Carpal Tunnel Syndrome
Carpal tunnel syndrome is a condition that causes tingling, numbness and pain in the hand and/or wrist.
It results from pressure on the median nerve, a major nerve of the hand and forearm. The median nerve extends through a narrow passageway called the carpal tunnel that connects the forearm to the hand.
Swelling of tendons is one of the causes of median nerve compression behind this condition. Pregnancy, chronic inflammation and fibrosis of the connective tissue are other causes. Because the median nerve is responsible for sensation in the thumb and first three fingers, pressure on this nerve causes changes in sensation in these digits. This nerve also controls important hand muscles, explaining why some carpal tunnel syndrome patients experience hand muscle weakness.
Wrist fractures, rheumatoid arthritis, repetitive movements, diabetes and hypothyroidism are all problems that can lead to carpal tunnel syndrome.
Treatment for carpal tunnel syndrome depends on the cause. Treatment may include conservative (non-surgical) options and surgery.
Carpal tunnel symptoms usually start gradually and tend to wax and wane. There are three types of symptoms with carpal tunnel syndrome:
- Tingling/numbness – the tingling and numbness usually affect the thumb and first three digits, but not the little finger. Those affected often describe this sensation as electric shocks running through the fingers and sometimes up to the arm. The numbness tends to become chronic after a while.
- Pain – pressure on the median nerve can also result in pain, which is usually felt in the wrist and hand. It may spread up the arm or down your fingers.
- Weakness – because carpal tunnel syndrome can also affect hand muscles, patients may notice gradual worsening of weakness in the hand that can make it difficult for them to grip objects.
Splinting
Using a splint at night to hold your wrist in proper alignment can reduce carpal tunnel syndrome symptoms during the day. This is a great option for patients who cannot use drugs to manage their condition.
Pain Medication
patients are usually given nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen to manage carpal tunnel syndrome pain. This option is for short-term relief only and is only used for pain management. It will not cure the condition.
Corticosteroids
Cortisone shots injected into the carpal tunnel can help to reduce swelling and inflammation. This can be done in-office, and often only a small number of injections are needed to provide relief.
Carpal Tunnel Syndrome Surgery
If you do not notice improvement with conservative treatment, surgery may be your next option. Carpal tunnel surgery involves cutting the ligament that is pressing the median nerve to relieve pressure. This is why carpal tunnel surgery is also known as “carpal tunnel release.”
Both techniques are performed in a hospital setting under local anesthesia. Each has unique advantages. Open surgery gives surgeons more control, while endoscopic surgery leads to quicker recovery. Both techniques come with similar success rates.
There are two surgical techniques for treating carpal tunnel syndrome:
- Open release surgery – In open release surgery, the surgeon makes a two-inch incision in the wrist to access the carpal tunnel and ligaments. They then cut the ligament to widen the carpal tunnel.
- Endoscopic surgery – In endoscopic surgery, the surgeon makes small incisions to insert an endoscope inside the carpal tunnel and cut the ligament. An endoscope is a tube with a light and camera attached to it. An ultrasound may be used in place of an endoscope.
What to Expect After Surgery
Your hand and wrist will be put in a bandage or splint that you will need to wear for up to two weeks. During your recovery, your hand will feel sore for a couple of weeks. You can manage this discomfort with pain medication.
The bandage or splint will be removed during a follow-up appointment, and you will be encouraged to start moving your hand and fingers. This is to prevent stiffness and aid in recovery. While initial swelling resolves soon after surgery, it can take a couple of months for your hand to heal completely. You should use your hand but avoid excessive pressure and straining until your ligaments have fully healed.
Make an Appointment at Cayman Islands Surgery Center
If you have carpal tunnel syndrome symptoms, contact us today to schedule an appointment at Cayman Islands Surgery Center. Dr. Tanja Ebanks is a general surgeon with years of experience treating a range of hand disorders, including carpal tunnel syndrome. She will carefully assess your condition and find the best treatment options for your case. To learn more about solutions for carpal tunnel syndrome, call Dr. Ebanks today at +1 345 946 0067. You can also fill out our online contact form to receive a callback at a more convenient time. You can message Cayman Surgery directly at office@caymansurgery.ky.
FAQS
Who gets carpal tunnel syndrome?
Anyone can develop carpal tunnel syndrome; however, women are three times more likely to develop the condition than men. That is likely because women naturally have smaller carpal tunnels than men. The condition is also more prevalent in people with certain medical conditions or who perform manual jobs that strain the wrist. It is rare to develop carpal tunnel syndrome at a young age.
Can carpal tunnel syndrome go away on its own?
Once you develop carpal tunnel syndrome, it is unlikely to go away without treatment. Symptoms may disappear for a while, only to come back later and become progressively worse.
Can carpal tunnel syndrome return after surgery?
Recurrence of carpal tunnel syndrome following surgery happens in up to 25 percent of all cases. Whether the condition reappears depends on how serious it was before surgery and a patient’s overall health, so many variables are involved.
What happens if my carpal tunnel surgery does not work?
Up to 12 percent of patients receiving carpal tunnel surgery may need to undergo re-exploration due to surgery failure. Some may need to undergo nerve grafting or a nerve wrap, however those are very rare measures.
How long does carpal tunnel surgery take?
The surgery itself should take no longer than 15 minutes. Patients may need to spend up to an hour in the hospital to be prepared for surgery and a bit more to monitor their recovery.
