Carpal tunnel surgery is an orthopedic procedure used to treat carpal tunnel syndrome – a common condition that causes numbness and weakness in the hand and arm.
If you are considering carpal tunnel surgery, it is important to ask your orthopedic surgeon plenty of questions to ensure you understand the risks and benefits associated with this type of surgery.
What Is Carpal Tunnel Syndrome?
The carpal tunnel is a narrow passageway that runs in the wrist on the palm side of the hand. It contains the median nerve – responsible for carrying signals for sensation and muscle movement. It is surrounded by bones and ligaments, including the transverse carpal ligament, which covers the top of the carpal tunnel.
Carpal tunnel syndrome occurs when the median nerve is compressed or entrapped, preventing it from function properly. The condition can cause symptoms, such as numbness, tingling, and weakness in the hand and arm, which usually start gradually. If left untreated, the condition can interfere with your normal activities and sleep quality, and may lead to permanent nerve and muscle damage.
Is Surgery The Best Option to Treat Carpal Tunnel Syndrome?
Symptoms of carpal tunnel syndrome can often be relieved successfully without surgery, particularly when treated as early as possible after the start of symptoms. Nonsurgical treatments can include:
- Activity modification or avoiding activities that make symptoms worse.
- Taking frequent breaks to rest the hands.
- Applying cold packs to help reduce swelling.
- Wearing a wrist splint at night to support the wrist in a neutral position and to help relieve symptoms. Wearing a splint may also be recommended during activities that aggravate symptoms.
- Over-the-counter medication, such as nonsteroidal anti-inflammatory drugs (NSAIDs), to reduce pain and swelling.
- Corticosteroid injections to reduce inflammation and relieve pressure on the median nerve.
- Treating an underlying medical condition that may be the cause of carpal tunnel syndrome, such as rheumatoid arthritis.
Surgery may be considered when nonsurgical options do not work successfully, or if the condition becomes worse and is significantly interfering with day-to-day life.
What Type Of Carpal Tunnel Surgery Is Best For Me?
The aim of surgery is to relieve pressure on the median nerve by cutting the problematic ligament that is placing pressure on the nerve. There are two main types of outpatient surgery to treat carpal tunnel syndrome, which include:
- Open release surgery – involves cutting through the ligament via an incision (over the carpal tunnel) in the palm of the hand.
- Endoscopic carpal tunnel release surgery – carried out using very small incisions and an endoscope (a small device with a light and a lens to allow the surgeon to view inside the carpal tunnel). The ligament is cut through a very small incision in the hand or wrist.
Your doctor will help you decide which option is best for you based on your condition, age, overall health, and other factors.
What Can I Expect During Surgery?
A carpal tunnel release procedure typically takes approximately fifteen minutes. For open release surgery, your orthopedic surgeon will use a local or regional anesthetic to numb the wrist and hand area. An incision approximately 1-2 inches long is made along the palm, which allows the surgeon to gain access to the transverse carpal ligament. The surgeon makes an incision in the ligament to make the tunnel larger and take pressure off of the median nerve.
Endoscopic carpal tunnel release usually only requires a local or regional anesthetic to numb the area. The orthopedic surgeon creates a very small incision below the crease of the wrist to insert the endoscope (to view the carpal tunnel), without disturbing the nearby tissues. A second incision may be made in the palm of the hand. A tube called a cannula is placed along the side of the median nerve (guided by the endoscope). The surgeon then inserts a special surgical instrument through the cannula to make an incision in the ligament to take pressure off of the nerve.
Are There Risks Associated With Carpal Tunnel Surgery?
Endoscopic carpal tunnel release surgery may result in less pain and a faster recovery, because it uses smaller incisions and causes less trauma to surrounding tissue. However, as with all types of surgery, there are risks associated with carpal tunnel surgery. You should discuss the risks and benefits of each surgical technique with your orthopedic surgeon prior to surgery.
Surgical risks can include:
- Wound infection
- Formation of scar tissue
- Incomplete release of the ligament
- Injuries to nearby blood vessels or nerves
What Is The Recovery Like After Surgery?
Following carpal tunnel surgery, your incision will be wrapped in a soft dressing. You will be able to move your fingers immediately, but any heavy grasping or pinching motions will need to be avoided for approximately six weeks. A splint may be recommended initially to provide support and promote healing.
Although the skin will heal within a few weeks, it can take several months for internal healing to be complete. As healing takes place, the ligament tissue will begin to grow back together gradually, allowing for more room for the median nerve.
It may take several months for strength in the wrist and hand to return to normal and for symptoms such as soreness and weakness to fully disappear. Physical or occupational therapy may be recommended following surgery to regain normal use of the hand and to improve strength, joint stability, and coordination.
Recovery from carpal tunnel surgery can vary and depends on the extent of the condition and the type of surgery performed. Your orthopedic doctor will be able to let you know what to expect.
Best Orthopedic Surgeon Near Me in Punta Gorda and Port Charlotte, Fl
If you are experiencing pain or loss of function in your hand, call to set up an appointment with Dr. Sean Spence, our hand and upper extremity specialist at Advanced Orthopedics Center. We use a variety of nonsurgical and surgical techniques to effectively treat bone, joint, tendon, ligament, cartilage, and muscular diseases and injuries.
If you would like to learn more about the services we offer or to book a consultation with one of our dedicated physicians, call us today at (941) 629-6262 or you can use our convenient online request form.