Hand is one of the important parts of the body for performing our daily activities. In case of carpel tunnel syndrome, person will have radiating pain, persistent numbness and tingling in his/her fingers or may experience weakness in hand sometimes. It is caused by pressure on the medium nerve which runs from the forearm to the hands. This can begin slowly and gradually progress. There are some non-surgical treatments like wrist braces or splints, cold or ice compress, physical therapy and medications such as anti-inflammatory, pain reliever, steroids (corticosteroids) that can help but if the person has severe problem then doctor may suggest surgery. Carpal tunnel syndrome can weaken the muscles of hands and wrist over the period of time and repetitive activities such as typing can worsen the condition further.
Doctor would perform a nerve conduction test and EMG (electromyogram) test to check for abnormal muscle electrical activity common in carpal tunnel syndrome. There are two main types of carpal tunnel release surgery:
1. Open carpal tunnel release - surgeon will make a small incision near the section of the palm near wrist. Then the carpal ligament will be removed which reduces the pressure on the medium nerve. Surgeon may also remove tissue from around the nerve depending on the case. Wound will be closed with few stitches and bandage will be applied to cover the wound afterwards.
2. Endoscopic carpal tunnel release – in this type of surgery, surgeon will make a small incision near the lower section of the palm near the wrist. He will then place a long thin flexible tube with a tiny camera known as endoscope in the opening of the wrist to guide and see the inside of the wrist as he cuts the ligament to reduce pressure on the nerve. Surgeon will then remove the endoscope and stitch back a wound.
Patient will be given anesthesia before the surgery to make him/her fall asleep and avoid any pain during the procedure.
Post carpal tunnel release surgery, surgeon will apply a splint or heavy bandage for about a week or two to protect patient’s hand and arm. Some medications such as pain relievers will be given to control the pain. Patient may also need to keep his/her hand elevated while sleeping to reduce swelling. Doctor will suggest patient not to lift heavy objects for some time, need to keep the bandage clean and dry. Once the splint or bandage is removed, patient has to undergo physical therapy or special exercises for hand and wrist for the faster recovery. Patient should inform the doctor in case of fever, redness, bleeding or other drainage from the wound, persistent and increased pain around the incision, nausea or vomiting, chest pain or breathing problem.
There are some risk and complications involved in the carpal tunnel surgery as following:
2. Infection at the wound site
3. Damage to surrounding nerves blood vessels.
4. Lymph nodes are swollen in the neck or underarms.