It is difficult to know how many in this country suffer from carpal tunnel syndrome because it often goes undiagnosed. People feel a slight tingling in one hand or numbness and ignore it or attempt to shake it off until it begins to affect their ability to use that hand. At that point, they may require carpal tunnel surgery.
Carpal tunnel syndrome refers to the pinching or squeezing of the median nerve that runs from your forearm to your palm. It gets its name from a narrow and rigid tunnel at the hand's base -- the carpal tunnel. The nerve runs through this tunnel up into the palm. Over time, the tunnel can thicken, compressing that nerve. This is what medical professionals call entrapment neuropathy, meaning the nerve is trapped in the tight tunnel.
At one time, it was thought to be strictly a repetitive use injury caused by the flexing of the wrist. Today, it’s clear that there is likely to be a genetic issue. Small carpal tunnels can run in families.
There may also be a connection to trauma like a fracture or repetitive use. There could be a link to diseases such as diabetes, thyroid disease, or rheumatoid arthritis, too. It might also have something to do with pregnancy.
Initially, the doctor will recommend nonsurgical interventions such as wearing braces. Eventually, it might be necessary to have surgery to release the trapped nerve. For many people, that will mean outpatient treatment at a surgical center such as Prime Surgical Suites.
There are two types of carpal tunnel surgery: open and endoscopic. Both have the same goal: cutting a ligament that goes across the carpal tunnel and traps the nerve. The open procedure is a more invasive approach that requires a longer recovery period. The open procedure might be necessary if the surgeon is treating another condition in the wrist, such as removing a tumor, for example.
The orthopedic surgeon makes a vertical incision at the base of the palm and down two inches over the wrist. This gives them a clear view of the transverse carpal ligament. Once that ligament is cut, the surgeon closes the incision with stitches. Over time, the gap between the two ends of the ligament will fill with scar tissue.
The open procedure typically requires a longer recovery time because the incision is larger. On average, recovery is six to eight weeks, and there may be some limitations on activities such as typing.
The endoscopic procedure requires a smaller incision, so the recovery time is generally shorter. The surgeon makes a small, horizontal incision at the palm's base. A thin, flexible tube with a camera goes into the incision to give the doctor access to the transverse carpal ligament. The surgeon uses a tiny blade on the flexible tool to cut the ligament.
Both surgeries require a local anesthetic to numb the hand. Afterward, you will wear a splint and heavy bandage to keep the wrist immobile while it heals. The splint and bandage stay in place for one to two weeks.
The decision to have surgery comes after other inventions fail to provide relief. Before the procedure, the doctor orders an electromyography test of the median nerve to determine if carpal tunnel syndrome is the correct diagnosis.
Surgery is important if other treatments don’t help because the hand's muscle tissue can waste due to the nerve's entrapment. That wasting can affect your use of the hand over time. A patient must have carpal tunnel syndrome symptoms for six months or longer before surgery becomes necessary.
At Prime Surgical Suites, we provide state-of-the-art, cost-effective musculoskeletal surgical care in a convenient and comfortable outpatient setting for patients of all ages. Located in RiverCrest Medical Park, we are the region's first outpatient center focused exclusively on orthopedics. Our physician-led center will help restore your active lifestyle and well-being with compassion and orthopedic excellence.