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When Is Surgery Needed For Carpal Tunnel

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Carpal Tunnel Surgery – Everything You Need to Know

Sometimes surgery doesn’t provide as much relief as expected. The symptoms may not go away, or they might come back afterwards. It’s difficult to predict how effective surgery will be. This may depend on things like how long you have had symptoms and how severe they are, or whether you have other illnesses. The chances of success are higher if the condition is in an earlier stage.

If the surgical procedure doesn’t have the desired outcome, there are a number of possible explanations:

  • The condition might already be at such an advanced stage that surgery can no longer make the symptoms go away completely.
  • The diagnosis was not correct. That means that the surgery was performed although something else was causing the symptoms.
  • If a mistake was made during surgery or the transverse carpal ligament wasn’t cut through completely. The symptoms may then persist or get worse.

If you still have severe symptoms even after surgery, it’s a good idea to be examined by a doctor again. More surgery may then be considered.

Signs You May Need Carpal Tunnel Surgery

Carpal tunnel syndrome causes obvious symptoms such as numbness and tingling in the hand, wrist, and fingers all fingers except the pinkie. It is caused by irritation or pressure being frequently placed on the median nerve, which runs from the forearm through the carpal tunnel in the wrist to the thumb, index finger, middle finger, and part of the ring finger.

Carpal means wrist, and the tunnel refers to the protective tube which houses the median nerve as it passes through the wrist. When the carpal tunnel is compressed, it puts pressure against the sensitive nerve. Patients with carpal tunnel syndrome are usually those in occupations that require heavy use of their arms and fingers, such as those who work at a computer all day. However, carpal tunnel syndrome can also develop due to other things, such as swelling of the hands due to fluid retention during pregnancy.

Mild cases may respond well to home treatments or physical therapy, but surgery is sometimes the only surefire way to relieve symptoms of the condition and prevent permanent disability. In the operation, the surgeon opens up and widens the tunnel, releasing the pressure on the nerve.

Lets talk about some of the signs that may indicate you need to have surgery for your carpal tunnel syndrome and who you can talk to in order to find out more.

Why Might I Need Carpal Tunnel Surgery

A diagnosis of carpal tunnel syndrome is about the only reason to have a carpal tunnel surgery. And even then, your doctor will likely want you to try nonsurgical treatments first. These may include over-the-counter pain medicines, physical therapy, changes to the equipment you use at work, wrist splints, or shots of steroids in the wrist to help relieve swelling and pain.

The reasons that a doctor would recommend a carpal tunnel release surgery may include:

  • The nonsurgical interventions for carpal tunnel syndrome don’t relieve the pain.
  • The doctor performs an electromyography test of the median nerve and determines that you have carpal tunnel syndrome.
  • The muscles of the hands or wrists are weak and actually getting smaller because of the severe pinching of the median nerve.
  • The symptoms of carpal tunnel syndrome have lasted 6 months or longer with no relief.

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Recovering After The Surgery

You can usually go home shortly after the procedure. Youll be given a prescription to help you manage any pain.

You should be able to do most light activities, such as driving and self-care tasks, while you recover. Your doctor will tell you when you can return to work or more strenuous activities.

Recovery can take anywhere from 2 months to a full year, depending on how severe your nerve damage was before surgery.

Most people have complete relief of their carpal tunnel syndrome after recovery is complete. Recovery can be slowed by other conditions that affect your joints and tendons. In rare cases, carpal tunnel syndrome can reoccur.

Your doctor will continue to monitor you after surgery to make sure youre making progress.

What Is Carpal Tunnel Release Surgery

Minimally Invasive Carpal Tunnel Release

Carpal tunnel release is a surgery used to treat and potentially heal the painful condition known as carpal tunnel syndrome. Doctors used to think that carpal tunnel syndrome was caused by an overuse injury or a repetitive motion performed by the wrist or hand, often at work. They now know that it’s most likely a congenital predisposition some people simply have smaller carpal tunnels than others. Carpal tunnel syndrome can also be caused by injury, such as a sprain or fracture, or repetitive use of a vibrating tool. It’s also been linked to pregnancy, diabetes, thyroid disease, and rheumatoid arthritis.

The median nerve and tendons that allow your fingers to move pass through a narrow passageway in the wrist called the carpal tunnel. The carpal tunnel is formed by the wrist bones on the bottom and the transverse carpal ligament across the top of the wrist. When this part of the body is injured or tight, swelling of the tissues within the tunnel can press on the median nerve. This causes numbness and tingling of the hand, pain, and loss of function if not treated. Symptoms usually start slowly, and may get worse over time. They tend to be worse on the thumb side of the hand.

During a carpal tunnel release, a surgeon cuts through the ligament that is pressing down on the carpal tunnel. This makes more room for the median nerve and tendons passing through the tunnel, and usually improves pain and function.

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Myth: Any Hand Pain Or Tingling Is A Sign Of Carpal Tunnel Syndrome Especially If You Use A Computer All Day

At the first sign of pain, numbness, or tingling in the hand or wrist, people may assume its a sign of carpal tunnel syndromeespecially if they sit at a computer for most of the day. Just as with any repetitive motion thats done for long periods of time, typing on a keyboard or using a computer mouse all day can cause aches and stiffness in the hands and wrists. But this isnt necessarily carpal tunnel syndrome.

See Is My Hand and Wrist Pain Caused by Carpal Tunnel Syndrome or Something Else?

Carpal tunnel syndrome has specific symptoms that set it apart from other conditions that can cause pain and numbness in the hand. For example, carpal tunnel syndrome typically causes tingling and numbness in the thumb, index, and middle fingers, but not the ring or pinky fingers. Also, the pain of carpal tunnel syndrome is usually worse at night.

See Distinctive Carpal Tunnel Syndrome Symptoms

Carpal Tunnel Release Surgery Duration

Carpal tunnel release surgery is performed on an outpatient basis, so you will likely be able to go home on the day of surgery.

If you have a job where you perform repeated actions at work, you can return to work within six to eight weeks. If you do not have a job where you perform repeated actions, you can return to work within seven to 14 days.

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Carpal Tunnel Release Surgery Expectations

Carpal tunnel release surgery can be performed via open release surgery or endoscopically.

During open release carpal tunnel release surgery, your surgeon will cut your wrist open to perform the surgery.

During endoscopic carpal tunnel release surgery, a thin, flexible tube is inserted into the wrist through an incision. The camera at the end of the instrument guides the doctor as he or she cuts the carpal ligament with small surgical instruments that have been guided into the wrist through the small incisions.

Pain or numbness may persist for several months after surgery, avoid heavy use of your hand for three months or more.

About Carpal Tunnel Release Surgery

Carpal Tunnel Syndrome Surgery Explained – Everything You Need to Know

Carpal tunnel release surgery also called carpal tunnel decompression involves cutting your carpal ligament. This ligament is connected to bones in your wrist to form the carpal tunnel. Several tendons and your median nerve, which controls movement and feeling in your hand, run through this tunnel to your fingers. In carpal tunnel syndrome, your median nerve becomes compressed, typically causing tingling, numbness and pain in your hand. Dividing the carpal ligament releases the pressure in your carpal tunnel and can ease your symptoms.

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What Is The Goal Of Carpal Tunnel Surgery

The goal of performing carpal tunnel surgery is to relieve pressure on the median nerve. This can be accomplished by cutting or releasing the transverse carpal ligament in the palm of the hand. A successful surgery is not only dependent on cutting this ligament to ensure pressure relief, but also being able to avoid causing harm to nearby structures. When performed by an expert hand surgeon, damage to any surrounding tissue can be avoided and will help speed up recovery time.

What Is The Success Rate For Carpal Tunnel Syndrome Surgery

Surgery for carpal tunnel syndrome has a very high success rate of over 90%. Many symptoms are relieved quickly after treatment, including tingling sensation in the hands and waking up at night. Numbness may take longer to be relieved, even up to three months. Surgery wont help if carpal tunnel syndrome is the wrong diagnosis.

When the carpal tunnel syndrome has become severe, relief may not be complete. There may be some pain in the palm around the incisions that can last up to a few months. Other after-surgery pain may not be related to carpal tunnel syndrome. Patients who complain of pain or whose symptoms remain unchanged after surgery either had severe carpal tunnel syndrome, had a nerve that was not completely released during surgery, or did not really have carpal tunnel syndrome. Only a small percentage of patients do not gain substantial relief from symptoms.

Last reviewed by a Cleveland Clinic medical professional on 10/22/2019.

References

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Find Relief With Carpal Tunnel Surgery

For most people, carpal tunnel surgery relieves pain for many years, but its important to follow Dr. Shults instructions following your carpal tunnel surgery. When you leave our office following surgery, your wrist is in a bandage and splint. It needs to stay splinted for a week or two.

After Dr. Shults removes your wrist splint, you start a physical therapy program. Recovery time varies, but full recovery can take up to a few months. While some pain following surgery is normal, you should tell Dr. Shults if you experience unusual symptoms, fever, or increased pain during recovery.

Throughout recovery, you move your fingers regularly and follow your physical therapy program to rebuild the strength in your wrist. Your carpal tunnel syndrome pain will disappear, and as your wrist heals, you can get back to work and the activities you love.

Carpal tunnel surgery is a long-lasting way to relieve your pain. Call Coastal Empire Orthopedics today or schedule an appointment online to learn more about the carpal tunnel syndrome treatment thats right for you.

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Carpal Tunnel Release Surgery

Carpal Tunnel Surgery: Preparation, Recovery, Long

Expert reviewers Giles Bantick, Consultant Plastic Surgeon and Hand Surgeon, and Dr Yasmin Rahman, Bupa Clinics GPNext review due September 2023

Carpal tunnel release surgery is an operation to relieve symptoms of carpal tunnel syndrome , including numbness, tingling and pain in your hand. The operation involves dividing a ligament in your wrist to relieve pressure on a nerve that controls movement and feeling in your hand.

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Final Months Of Aftercare

The final phase of your aftercare can last for a couple months up to a year. It depends on you, including your ability to heal and the amount of effort you put into rehabilitation and strengthening your hand.

If your job doesnt require a lot of manual work, then returning to work will be relatively easy but you may need to take occasional short breaks for hand rests. Again, this assumes you experienced no surgical complications.

Finally and this may sound odd but pay special attention to yourjob function.Thats because carpal tunnel syndrome is an occupational disease. That means the job probably allowed the condition to develop in the first place. High-risk jobs that require a lot of forceful and repetitive hand movements.

Guide To Aftercare For Carpal Tunnel Surgery

It’s at home, after the operation, that your aftercare for carpal tunnel surgery actually begins. It’s also the beginning of a long haul. But with the right preparation it will be over before you know it.

Getting comfortable with knowing what to expect aftercarpal tunnel release surgeryis the smart thing to do right now. Easing the anxiety about the unknown makes life better all around. So understanding whatto expect andwhenis a great start.

Depending on how fast you heal and how well you manage the pain, aftercare is usually relatively simple. YES, there will be post-surgical pain to deal with. And that’s why you’ll have pain medicines on hand.

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The only other major concern to think about is the possibility ofcomplicationsduring recovery. Common complications include problems like delayed reaction to the anesthesia, bleeding, infection or nerve damage. Any of those can make the surgery aftercare more lengthy and complicated.

But lets stay positive! We’ll assume there won’t be complications and all goes well during yourcarpal tunnel surgery recovery.

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Type Of Carpal Tunnel Surgery You’ll Have

Everybody who undergoes carpal tunnel surgery will have one of two basic types of operative procedures:

Both operative techniques have significantpros and consassociated with them. But the aim of each technique is identical to allow access to your wrist’s interior.This lets the surgeon see yourtransverse carpal ligament.Then he or she uses a scalpel to cut it in half.

The reason for cutting the ligament is to free up more space inside the wrist joint. Think of it like cutting the string of an archery bow. When the ligament is cut, the bones snap apart much like the bow would. The result is that more space is created, whichdecompressesthe median nerve. Doing so relieves the symptoms of the crushed median nerve.

Both operative procedures take about 45 minutes to complete. They’re usually performed on an outpatient basis. Thecost of carpal tunnel surgerycan vary greatly between the procedures.

OPEN Carpal Tunnel Release Surgery

For this type of surgery you can have either local or general anesthesia. The actual surgical technique requires the doctor making a 2-3 inch long incision in your palm. Then the surgeon with a clear view of the transverse carpal ligament cuts it in half.

ENDOSCOPIC Carpal Tunnel Release Surgery

If The Pain Has Become Unbearable And No Therapeutic Or Medical Treatments Have Worked It Might Be Time To Consider Surgery For Your Carpal Tunnel Syndrome

What to expect: Carpal tunnel surgery in the clinic

Carpal tunnel syndrome is a compression of the median nerve that runs through your wrist.

Women are three times more likely to develop the condition, and people in assembly-line work often are affected by it. The result is nagging pain, tingling and numbness in the hand, fingers or thumb. Upon diagnosis, your doctor may recommend a night splint, medical treatments and a variety of therapies to alleviate the pain.

Think of the hand as a plant, while the median nerve, which supplies power and feeling to the hand, is similar to a garden hose. If the garden hose is compressed, then the plant will not receive what it needs to function. This is when patients have symptoms. Surgery is designed to take the pressure off the hose and allow the water to flow.

At centers such as the USC Hand Center at Keck Medicine of USC, certified hand therapists combine occupational therapy and physical therapy techniques to assess your injury and restore function. Once you have exhausted these options, surgery may be the only way to relieve pain or cure your carpal tunnel syndrome. Only in rare cases will your doctor suggest surgery if your symptoms have just started.

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Why Have Carpal Tunnel Surgery

Left untreated, severe carpal tunnel syndrome can lead to permanent nerve damage.

“If your symptoms are getting worse or aren’t improving with treatment, it’s important to let your doctor know,” explains Dr. Alexander. “Carpal tunnel syndrome can progress and become severe, potentially leading to loss of dexterity, sensation, and fine motor skills.”

Dr. Alexander says it’s time to consider surgery when conservative approaches aren’t enough or if the severity is a concern.

“If your pain is continuous and has progressed to the point that it’s interrupting your everyday life, it’s likely time for surgery,” explains Dr. Alexander. “Of course, we may also recommend surgery if your clinical exam or test results indicate that we need to intervene before your condition get worse.”

Symptoms Of Carpal Tunnel Syndrome

As the median nerve becomes crushed, it produces paresthesia,or abnormal sensations. These include feelings of pain, numbness, burning, pins & needles or weakness.

These feelings are distributed on the fingers and palm as shown in the illustration to the left. Note how only certain parts of the fingers and hand are affected by carpal tunnel syndrome.

When it starts out, carpal tunnel syndrome usually only appears while you’re trying to sleep. As it progresses, symptoms seem to come and go during the day. Sometimes you feel shooting electric shocks in your hand.

More severe symptoms truly interfere with your daily life. They include much more intense paresthesia . They also include loss of dexterity, diminished grip strengthand loss of temperature sensitivity.

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