Understanding Carpal Tunnel Syndrome

Beware of Hand Pain

Most of us use our hands almost every minute of the day without a second thought. But if you suffer from carpal tunnel syndrome, the pain, numbness, and tingling in your fingers will grab your attention. Treatments such as wearing hand and wrist splints and corticosteroids can help, but in more severe cases, you may need surgery.

 

What Causes Carpal Tunnel?

Carpal tunnel syndrome is caused by pressure on the median nerve. This is the nerve that allows you to feel touch in your thumb and all your fingers except your little finger. As the nerve passes through your wrist, it goes through the carpal tunnel: a narrow passageway made of bone and ligaments. If your wrist is swollen, this tunnel narrows and pinches your median nerve. This is what causes your symptoms of pain, tingling, and numbness.

Whether you've decided to have surgery or are still considering it, you need to know what to expect.

Carpal Tunnel Surgery

When to Have Carpal Tunnel Surgery?

Over time, carpal tunnel syndrome can weaken the muscles in your hands and wrists. If symptoms last too long, your condition will continue to worsen.

If any of the following situations sound like you, your doctor might suggest carpal tunnel surgery:

• Other treatments, such as braces, corticosteroids, and changes to your daily routine, haven't helped;
• You have pain, numbness, and tingling that doesn't go away or improve within six months;
• You have more difficulty grasping, gripping, or pinching objects as you once did;

What are the Carpal Tunnel Surgical Options?

There are two main types of carpal tunnel release surgery: open and endoscopic. In both, your doctor cuts the ligament around the carpal tunnel to take the pressure off the median nerve and relieve your symptoms. After surgery, the ligament reforms, but with more room for the median nerve to pass through.

• Open surgery involves a larger cut, or incision, up to 5 cm from your wrist to the palm of your hand;
• In endoscopic surgery, your surgeon makes one opening in your wrist. They may also make one in your forearm. These cuts are smaller, about 1 cm each. They then place a small camera in one of the openings to guide them as they cut the ligament;

Because the openings are smaller with endoscopic surgery, you may have faster healing times and experience less pain. Ask your doctor which surgery is best for you.

 

How to Prepare for Carpal Tunnel Surgery?

• • Tell your doctor about all the medications you are currently taking. You'll likely need to stop taking any medication that makes your blood harder to clot, such as ibuprofen, aspirin, or naproxen;
  • If you are a smoker, try to quit before surgery. Smoking can delay healing;
  • You may need to have blood tests or an electrocardiogram (ECG) before surgery;
  • You'll usually be asked not to eat or drink for 6 to 12 hours before surgery;
  • Depending on your health condition, your doctor may ask for other specific preparations;

How is Carpal Tunnel Surgery Performed?

When you have carpal tunnel surgery, you'll first receive local anesthesia, which means medication to numb your hand and wrist. General anesthesia, which means you won't be awake during surgery, isn't common for carpal tunnel syndrome.

Once the surgery is complete, your doctor will stitch up the openings and put a large bandage on your wrist. This protects your injury and keeps you from using your wrist.

Your doctor and nurses will monitor you for a while before letting you go home. You'll likely leave the hospital the same day. Stays of more than 24 hours are rare.

 

Results and Risks

The Results of Carpal Tunnel Surgery

Most people who have carpal tunnel surgery find that their symptoms heal and don't return. If you have a very severe case, surgery can still help, but you may still experience occasional numbness, tingling, or pain.

 

The Risks and Complications of Carpal Tunnel Surgery

Any surgery carries risks. For both types of carpal tunnel surgery, these risks include:

• Bleeding;
• Damage to the median nerve or nearby nerves and blood vessels;
• Infection of your wound;
• A scar that is painful to the touch;

How Long Does it Take to Heal After Carpal Tunnel Surgery?

You may get relief from symptoms the same day of your carpal tunnel surgery, but full recovery takes longer. Expect to have pain, swelling, and stiffness after surgery. Your doctor will tell you which medications might help. You may have some pain for a few weeks or a few months after surgery.

Your bandage will stay on for one to two weeks. Your doctor may give you exercises to do during this time to move your fingers and keep them from becoming too stiff. You can use your hand lightly during the first two weeks, but avoid too much strain.

Slowly, you can resume more normal activities, such as:

• Driving (a few days after surgery);
• Writing (after a week, but expect 4-6 weeks before it's easier);
• Pulling, grasping, and pinching (after 6-8 weeks, but only lightly. Expect 10-12 weeks before regaining full strength, or up to a year in more severe cases);

Your doctor will tell you when you can return to work and if you'll be limited in what you can do.

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