Carpal Tunnel Surgery: Recovery and Postoperative Care

What is Carpal Tunnel Surgery?

The carpal tunnel is located at the base of the palm. It houses the flexor tendons and the median nerve. When there is significant pressure inside this tunnel, it can lead to carpal tunnel syndrome. This increased pressure is due to the compression of the median nerve. Carpal tunnel surgery aims to enlarge the space within the tunnel to relieve the nerve. This is done by cutting the transverse carpal ligament, which forms the roof of the tunnel on the palm side.

What are the Symptoms of Carpal Tunnel Syndrome?

Carpal tunnel syndrome is a common disorder affecting the carpal tunnel, causing a variety of uncomfortable symptoms. Recognizable signs include constant pain, numbness, tingling, and weakness in the hand and fingers. Also called carpal tunnel syndrome, it's caused by compression of the median nerve at the carpal tunnel. Recognizing its symptoms is crucial. If in doubt, consult a healthcare professional for accurate diagnosis and prompt treatment. Don't ignore these common signs; act quickly to relieve your symptoms.

How is Carpal Tunnel Syndrome Treated?

Carpal tunnel syndrome is a frequent problem caused by compression of the median nerve in the carpal tunnel located in the hand. The most common signs include pain, numbness, tingling, and weakness in the hand and fingers. Management of carpal tunnel syndrome varies depending on symptom severity. In mild to moderate cases, wearing a wrist splint to maintain and stabilize the hand is often recommended, reducing nerve pressure. A doctor may prescribe anti-inflammatory medications and physical therapy to relieve pain and improve hand function. However, if these treatments are ineffective or the condition is severe, carpal tunnel surgery may be necessary. This procedure aims to release the median nerve by cutting the ligament compressing the carpal tunnel, improving circulation and reducing nerve pressure. It's essential to tailor carpal tunnel syndrome treatment to each individual, using solutions ranging from conservative methods like splinting and medication to hand surgery if needed.

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When is Carpal Tunnel Surgery Performed?

Carpal tunnel surgery is considered when symptoms in the palm become particularly difficult to manage. After exhausting unsuccessful medical treatments, this procedure is often recommended. Symptoms include tingling, sharp pain, numbness, and weakness in the hand.

How is Carpal Tunnel Surgery Performed?

Open Surgery

In carpal tunnel surgery, the doctor makes a 3-4 centimeter incision on the wrist, specifically between the hand and wrist. Then, gently separating the skin layers, they expose and dissect the carpal ligament to release the median nerve from compression. At the end of the decompression procedure, they close the skin flaps and apply sutures, which may be absorbable or non-absorbable.

Endoscopic Surgery

In endoscopic carpal tunnel surgery, the surgeon may make one or two small, one-centimeter incisions in the wrist and/or palm. These openings are used to insert the arthroscope (or endoscope) and surgical instruments to dissect the carpal ligament and release the median nerve. The arthroscope and endoscope are special instruments with similarities: they have a camera connected to a monitor, providing a view inside the wrist and carpal tunnel. Once the main ligament is dissected and the instruments are removed, the surgeon closes the incisions.

Carpal Tunnel Surgery: Postoperative Care

Healing Time

Carpal tunnel surgery weakens hand strength and reduces wrist and finger joint function. Full recovery of these functions and healing of the severed ligament takes several weeks, even months.

What Affects Recovery?

Postoperative recovery depends on these factors:

• Type of surgery. The skin wound from open surgery takes several more weeks to close than the two small incisions from closed procedure. If the former takes approximately 6 weeks, the latter takes only a few weeks;
• To improve hand function and strength, it's crucial to carefully follow your doctor and physical therapist's instructions. Their expertise will help you reach this goal faster, so follow their advice closely;
• Your work. Manual labor, especially strenuous manual labor, slows ligament and skin wound healing. The doctor therefore recommends resuming such work activities cautiously, paying attention to certain movements and taking short breaks between tasks;

Physical Therapy

Physical therapy plays a key role in recovering hand and wrist joint function and muscle strength. Therefore, it is important to emphasize the importance of following your physical therapist's instructions and rehabilitation exercises.

Where and How Severe is Carpal Tunnel Pain?

Carpal tunnel syndrome is characterized by pain primarily in the wrist and hand, but it can also radiate along the forearm and sometimes even to the shoulder. Located in the wrist, the carpal tunnel is a narrow passage where the median nerve and finger flexor tendons cross. When this tunnel is inflamed or compressed, it can cause symptoms like tingling, numbness, and pain. Pain intensity varies greatly, from mild discomfort to sharp, persistent pain. Carpal tunnel syndrome can be triggered by wrist movements, repetitive actions, or excessive pressure on the area. This pain can also extend to the fingers, particularly the thumb, index, middle, and ring fingers. The causes can be varied, such as inflamed tendons, arthritis, injuries, genetic predispositions, or jobs requiring constant wrist use. Consult a healthcare specialist as soon as you experience carpal tunnel pain. Accurate diagnosis and appropriate treatment can not only relieve symptoms but also prevent potential long-term complications. Act for your health!

When Should Sutures Be Removed?

Absorbable sutures usually dissolve in 7-10 days. The attending physician removes non-absorbable sutures after 10-14 days.

What are the Risks and Complications Associated with Carpal Tunnel Surgery?

Carpal tunnel surgery has a positive record in terms of effectiveness and safety. However, like any surgery, it carries risks and potential complications. It can lead to:

• Intense and prolonged pain: Post-operative recovery often involves mild, temporary pain. However, sometimes it persists longer, causing discomfort. When this occurs, the painful area includes both the hand and wrist;
• Visible scarring: Open surgery is more likely to leave deep, visible skin marks;
• Prolonged numbness: Numbness typically lasts a few weeks, but in some cases, it can remain for several months. Often, in these circumstances, it's accompanied by intense pain;
• Infection: These are due to bacteria entering the wound. To resolve this, antibiotics are needed. Main signs of infection include wound redness, pus leakage, and high fever;
• Bleeding can occur during surgery if the surgeon accidentally injures a blood vessel, or post-operatively if the patient hits the operated area against an object;
• Permanent median nerve damage: During surgery, a doctor may unintentionally injure the median nerve. Symptoms of this damage are persistent numbness and tingling. This is rare;
• Tendon damage: In these instances, a second corrective surgery is necessary. This is rare;
• Weakness in gripping objects and joint stiffness: Some patients experience difficulty gripping objects due to weakness or excessive joint stiffness. Generally, these circumstances resolve spontaneously, although over a fairly long time;
• Recurrence: If symptoms don't improve in the months that follow, a second operation is necessary. This is, however, very rare;

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