Carpal tunnel syndrome is a condition that affects the wrist and hand. It occurs when the median nerve, which passes through the carpal tunnel in your wrist, becomes compressed or irritated. The carpal tunnel is made up of bones and ligaments and when these tissues become swollen or inflamed, it can place pressure on the nerve resulting in pain, numbness, and/or tingling in the fingers. During a carpal tunnel release surgery, 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.
What anatomy is involved in carpal tunnel?
The carpal tunnel is formed by the wrist bones and ligaments, with the median nerve passing through. The tendons of several muscles also pass through the carpal tunnel, including those that move the thumb, index finger, and middle finger.
The most common symptoms of carpal tunnel syndrome
The most common symptoms of carpal tunnel syndrome include:
- Pain or discomfort in the wrist and hand.
- Numbness or tingling of the fingers (especially the thumb, index finger and middle
- finger).
- A burning sensation in the palm of the hand.
- Frequent muscle cramping in the hand, and weakness in the grip.
If you are experiencing any of these symptoms, it is important to talk to an orthopedic surgeon as soon as possible. Dr. Giang would be happy to talk to you about your treatment options.
Who is at risk for developing carpal tunnel syndrome?
Certain factors may increase your risk for developing carpal tunnel syndrome.
- Gender: Women are three times more likely to develop carpal tunnel syndrome than men.
- Age: It usually affects adults between 30-60 years old but can occur at any age.
- Medical conditions: People with diabetes, rheumatoid arthritis, and thyroid disorders or other metabolic disorders that directly affect the body’s nerves and make them more susceptible to compression are also at high risk.
- Occupation: Frequent, repetitive, motions with your hands (such as typing) may cause inflammation in the carpal tunnel.
- Injury: A sprain or fracture, or repetitive use of tools.
- Genetics: Family history of carpal tunnel syndrome, some people have smaller carpal tunnels than others.
Treatment options for carpal tunnel
Treatment options for carpal tunnel syndrome include rest, physical or occupational therapy to help strengthen muscles and reduce stress on the wrist joint. Treatments like wearing a wrist brace, taking non-steroidal anti-inflammatory medications or other pain relievers, and corticosteroids can help, but in more severe cases, you may need surgery. It is important to talk to your orthopedic surgeon to decide what treatment options are best for you.
Types of carpal tunnel release surgery
There are two main types of carpal tunnel surgery: open and endoscopic.
- Open carpal tunnel release is the traditional surgical method in which the surgeon makes an incision up to 2 inches from your wrist to your palm.
- Endoscopic carpal tunnel release is alternative method in which a smaller incision is made (about a half inch), allowing a thin, tube containing a camera to be placed into the wrist. The camera guides the doctor as the surgery is done with thin tools put into the wrist through the same or additional small incision.
In both cases, the orthopedic surgeon cuts the ligament around the carpal tunnel to take pressure off the median nerve and relieve your symptoms. After surgery, the ligament comes back together, but with more room for the median nerve to pass through. The benefit to endoscopic carpal tunnel surgery is that with smaller incisions, you may heal faster and have less pain. Carpal tunnel release is a quick (usually around 30 minutes long) surgery and is usually done as an outpatient procedure, meaning that you can go home the same day as the surgery.
Why have carpal tunnel release surgery?
Carpal tunnel release surgery may be recommended when conservative treatments have failed to relieve symptoms. Surgery can help reduce pain, tingling and numbness in the hand as well as improve strength and function of the hand. The surgery is typically performed under local anesthesia. A small incision is made near the wrist, though some surgeons may choose to use a minimally invasive technique through endoscopic surgery. Each patient is unique, and therefore, Dr. Giang will help you decide which operation would be best for you and your situation.
Recovery after carpal tunnel release surgery
After surgery, you will likely feel relief, but it is not uncommon that most patients may experience some soreness and swelling in the wrist and hand. To help reduce pain and inflammation, rest and ice as recommended. A wrist splint or brace may be prescribed for several weeks after surgery to keep the carpal tunnel open and allow for optimal healing. Physical therapy may also be beneficial in improving range of motion and strength. In most cases, full recovery can be expected within 3-6 months after surgery.
How to prevent carpal tunnel syndrome
You may be able to prevent carpal tunnel syndrome from developing by taking steps to minimize strain on your wrists.
- Take breaks while typing or doing other repetitive activities with your hands.
- Position yourself correctly while typing and use a wrist brace if needed.
- Exercise regularly to strengthen muscles throughout the body, including those in the wrist.
FAQ
Q: What is carpal tunnel release surgery?
A: Carpal tunnel release surgery is a procedure done to relieve pressure on the median nerve in the wrist. It is usually performed under local anesthesia and involves making an incision to cut the transverse carpal ligament, allowing more room for the nerve to pass through. This may be done as a traditional open approach or with a minimally invasive technique called endoscopic carpal tunnel release surgery.
Q: Who is a candidate for carpal tunnel release surgery?
A: Carpal tunnel surgery may be recommended for those who have tried conservative treatments without relief of their symptoms and experience pain, tingling and/or numbness in the hand due to carpal tunnel syndrome.
Q: What is endoscopic carpal tunnel release surgery?
A: Endoscopic carpal tunnel release surgery is a minimally invasive surgery that involves making an incision in the wrist and inserting a small camera to view the carpal tunnel. The surgery can be done with local or general anesthesia, and it typically takes less than 30 minutes. During surgery, your doctor will use specialized instruments to cut the transverse carpal ligament, which frees up space in the carpal tunnel and reduces pressure on the median nerve. Endoscopic carpal tunnel surgery is less invasive than traditional surgery and typically has a shorter recovery time.
Q: How long does it take to recover from carpal tunnel release surgery?
A: Recovery time can vary depending on the individual, but in most cases full recovery is expected within 3-6 months after surgery. During this time, rest and physical therapy may be beneficial for improving range of motion and strength.
Q: Are there risks associated with carpal tunnel release surgery?
A: As with any surgery, there are potential risks associated with carpal tunnel surgery such as infection, nerve damage and scarring. Be sure to discuss any concerns with your doctor before undergoing surgery.
Q: How do you get rid of carpal tunnel syndrome?
A: There is no sure-fire way to get rid of carpal tunnel syndrome, but certain treatments can help manage and reduce symptoms. These treatments include rest, splinting, anti-inflammatory medications, physical therapy and surgery. Carpal tunnel surgery may be recommended when other treatments have failed to provide relief.
Q: Does carpal tunnel go away on its own?
A: In some cases, carpal tunnel syndrome may improve over time without surgery. However, if symptoms are severe and causing disruption to daily activities, surgery may be recommended for optimal relief of symptoms.
Carpal tunnel surgery can offer hope to those who have experienced chronic pain and discomfort due to carpal tunnel syndrome. If you think you might be a candidate, talk to Dr. Giang about carpal tunnel surgery and if it might be right for you. He can evaluate your condition and discuss the benefits and risks of surgery so that you can make an informed decision. With proper treatment, carpal tunnel syndrome can be managed, allowing you to live an active life, free from pain.
Q: What should I expect after carpal tunnel release surgery?
A: After surgery, most patients experience a gradual decrease in symptoms as the inflammation subsides. It is important to follow your doctor’s instructions for post-operative care, which may include wearing an immobilizing splint or brace for a period and avoiding activities that put strain on the wrist. Physical therapy may also be recommended to help improve strength and range of motion in the hand and wrist.
Q: What causes carpal tunnel syndrome?
A: Carpal tunnel syndrome occurs when the median nerve, which runs through the carpal tunnel in the wrist, becomes compressed. This can be caused by a variety of factors such as repetitive motions or activities that involve gripping and squeezing tools or objects for extended periods of time. Certain medical conditions such as diabetes, rheumatoid arthritis, hypothyroidism and obesity can also cause carpal tunnel syndrome.
Q: Can you prevent carpal tunnel syndrome?
A: Carpal tunnel syndrome can be prevented by taking certain precautions. Working with your doctor to identify potential risk factors for carpal tunnel syndrome and develop an action plan to reduce or avoid them is the best way to prevent this condition from developing or worsening. Taking regular breaks from activities that involve repetitive motions, adjusting posture while typing, using a wrist brace and exercising regularly can also help protect against carpal tunnel syndrome. Additionally, stretching and strengthening exercises can help build strength in the muscles and tendons of the wrist, reducing strain on the carpal tunnel.
Q: What are the symptoms of carpal tunnel syndrome?
A: The most common symptoms of carpal tunnel syndrome include numbness and weakness in the hand and fingers, tingling or burning sensations, pain in the wrist and forearm, reduced grip strength and clumsiness when trying to grasp small objects. If you are experiencing these symptoms or have any questions about carpal tunnel surgery, don’t hesitate to contact Dr. Giang for an evaluation.
Carpal tunnel syndrome can be a debilitating condition that affects daily activities. If conservative treatments have failed to provide relief, surgery for carpal tunnel syndrome may be an option for those who experience pain, tingling and/or numbness in the hand due to carpal tunnel. It is important to discuss any concerns with your doctor before undergoing surgery so that you can understand all the potential risks involved. With proper care and rest, most patients can expect to make a full recovery within 3 to 6 months.
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