Carpal tunnel release is surgery to treat carpal tunnel syndrome. Pressure on the median nerve in the wrist causes this syndrome of pain and weakness in the hand.
What is Carpal Tunnel Syndrome?
Carpal tunnel syndrome is a condition affecting one of the main nerves in the wrist area. The carpal tunnel is a space created by the natural arch of the wrist bones. A thick band called the transverse carpal ligament creates a roof to the tunnel. This means that the size of the tunnel cannot change, as the bones and ligaments act like solid walls. Nine tendons that bend the fingers and thumb and the median nerve pass through the tunnel. The median nerve provides feeling to the skin of the thumb, index, and middle fingers, as well as half the ring finger. The nerve also provides the communication line to the muscles at the base of the thumb.
Why might I need carpal tunnel surgery?
Carpal tunnel syndrome (CTS) is a common condition that causes pain, numbness, and tingling in the hand and arm. It occurs when one of the major nerves in the hand — the median nerve — is squeezed or compressed as it travels through the wrist. In most patients, carpal tunnel syndrome gets worse over time, so early diagnosis and treatment are important.
Early on, symptoms can often be relieved with simple measures like wearing a wrist splint or avoiding certain activities. However, as the condition worsens, these measures may not be effective. If left untreated, CTS can lead to severe pain, weakness, or even permanent nerve damage. This is where carpal tunnel surgery comes into play.
Carpal tunnel surgery, also known as carpal tunnel release, is a procedure used to relieve pressure on the median nerve. The surgery involves cutting the band of tissue around the wrist to reduce pressure on the median nerve. This procedure is generally recommended when CTS symptoms are severe or do not improve with non-surgical treatments.
There are several reasons why you might need carpal tunnel surgery. If your symptoms have lasted 6 months or more with no relief from non-surgical treatments, surgery may be an option. Severe cases of CTS can cause loss of feeling and coordination in the fingers and thumb, and even decrease strength in the hand, making it difficult to grasp small objects or perform other manual tasks. If you’re experiencing these symptoms, surgery may be necessary to prevent permanent damage and restore function to the hand.
How do I get ready for carpal tunnel surgery?
Preparing for carpal tunnel surgery involves several steps to ensure a successful procedure and recovery. Here are some key points to consider:
Firstly, you’ll have a thorough discussion with your surgeon about the procedure, its risks, benefits, and the expected recovery process. This will help you understand what to expect and make an informed decision.
Before the surgery, you’ll likely undergo a physical examination to assess your overall health. This may include blood tests, an electrocardiogram (ECG), and other necessary evaluations. If you have any chronic conditions like diabetes or heart disease, make sure your doctor is aware as these could affect your surgery and recovery.
You may need to stop taking certain medications before surgery, especially those that can increase bleeding, such as aspirin, ibuprofen, and certain dietary supplements. Always consult with your doctor or pharmacist before stopping any medication.
Smoking can delay healing, so if you’re a smoker, try to quit or cut down before your surgery. Also, maintain a healthy diet as good nutrition can aid in recovery.
Arrange for someone to drive you home after the surgery as you won’t be able to drive immediately. Also, prepare your home for your recovery.
On the day of the surgery, follow your doctor’s instructions about eating and drinking. Typically, you’ll be asked to fast (not eat or drink anything) for several hours before the procedure.
Lastly, it’s normal to feel anxious before surgery. Techniques such as deep breathing, visualization, or listening to calming music can help reduce anxiety.
What is carpal tunnel release surgery?
Carpal tunnel release is the surgery used to treat and heal the painful condition known as carpal tunnel syndrome. Although it was thought that carpal tunnel syndrome was caused by an overuse injury or a repetitive motion performed by the wrist or hand, it’s now understood that it’s a congenital predisposition. Some people simply have smaller carpal tunnels than others. Carpal tunnel syndrome can also be caused by injury, such as a sprain or fracture, or repetitive use of a vibrating tool. It's also been linked to pregnancy, diabetes, thyroid disease, and rheumatoid arthritis.
Your median nerve and tendons allow the fingers to move through a narrow passageway in the wrist called the carpal tunnel. When your wrist bone is injured or tight, it causes swelling of the tissues within the tunnel and presses on the median nerve. Causing numbness and tingling of the hand, pain, and loss of function if not treated. As the symptoms gradually start, they tend to worsen especially on the thumb side of the hand. During carpal tunnel release surgery, a cut is made on the ligament that is pressing down on the carpal tunnel. This makes more room for the median nerve and tendons passing through the tunnel and usually improves pain and function.
What happens during carpal tunnel surgery?
Carpal tunnel surgery, also known as carpal tunnel release, is a procedure performed to alleviate symptoms of carpal tunnel syndrome. The surgery aims to relieve pressure on the median nerve, which passes through the carpal tunnel in your wrist and provides sensation to your thumb, index, middle, and part of your ring finger. The surgery can be performed using two different techniques: open-release surgery and endoscopic surgery. Both procedures involve cutting the transverse carpal ligament to relieve pressure on the median nerve.
In open-release surgery, the surgeon makes a small incision in the palm of your hand over the carpal tunnel and cuts through the ligament to free the nerve. The skin is then stitched back together. This procedure allows the surgeon to directly view the treatment area.
In endoscopic surgery, the surgeon makes one or two smaller incisions in your hand or wrist. A tiny camera (endoscope) is inserted through the incision, allowing the surgeon to see inside your carpal tunnel on a monitor. The surgeon uses a small knife, inserted through the same incision or another small incision, to cut the carpal ligament.
Both procedures are typically performed under local anesthesia, so you’ll be awake but won’t feel any pain in your hand or wrist during the surgery. The choice between open and endoscopic surgery depends on your specific condition, your surgeon’s expertise, and your personal preference. After the ligament is cut, the pressure on the median nerve is relieved right away. Over time, the incision scars will heal, but the space in the carpal tunnel remains larger than before, which means the median nerve has more room.
Carpal tunnel surgery risks
You may experience numbness in your wrist following a carpal tunnel release surgery. Other potential risks of a carpal tunnel release surgery include:
Bleeding
Infection
Injury to the median nerve or nerves that branch out from it
Injuries to nearby blood vessels
A sensitive scar
Carpal tunnel surgery recovery
Following surgery, your doctor will apply a dressing to your hand. As you’ll need to protect your hand post-op as it heals, you may need assistance with daily activities. For good healing, avoid wetness on the stitches and skin. Stitches are removed about two weeks after surgery. It’s important to not use your hand for one month after surgery. The majority of patients recover completely. Your recovery journey will involve splinting your wrist and getting physical therapy to strengthen and heal the wrist and hand.
What happens after carpal tunnel surgery?
After carpal tunnel surgery, you’ll be moved to a recovery room where your healthcare team will monitor you as the anesthesia wears off. You’ll likely be able to go home the same day, but you’ll need someone to drive you as you may still be under the effects of the anesthesia.
In the first few days after surgery, it’s important to keep your hand elevated above your heart as much as possible to help reduce swelling and pain. You may also be advised to move your fingers to help prevent stiffness.
Pain is a common side effect after surgery, but it should gradually improve over time. Your doctor will likely prescribe pain medication to help manage this. If the pain worsens or doesn’t improve, it’s important to contact your doctor.
You’ll have a bandage over your incision, which you’ll need to keep dry for a few days. Your doctor will give you specific instructions on when and how to change the bandage. You may also have stitches, which will either dissolve on their own or need to be removed at a follow-up appointment.
Physical therapy is often recommended after carpal tunnel surgery to help restore strength and flexibility to your wrist and hand. This usually starts a few weeks after surgery, once the incision has healed.
It’s important to note that recovery times can vary. Some people may regain full use of their hands and wrists within a few weeks, while others may take several months. Factors such as the severity of your carpal tunnel syndrome before surgery, your overall health, and how well you follow your doctor’s post-surgery instructions can all affect your recovery.
Conclusion
In conclusion, Carpal Tunnel Release is a surgical procedure that provides significant relief from the symptoms of Carpal Tunnel Syndrome. This condition, which causes pain, numbness, and tingling in the hand and arm, can severely impact a person’s quality of life. The surgery involves relieving pressure on the median nerve by cutting the transverse carpal ligament. While non-surgical treatments can be effective in the early stages, surgery may be necessary for severe cases or when symptoms persist despite conservative treatment. Both open and endoscopic techniques are used, with the choice depending on various factors including the surgeon’s expertise and the patient’s preference. Post-operative care, including pain management and physical therapy, is crucial for a successful recovery. While the procedure has a high success rate, it’s important for patients to have realistic expectations and understand that in some cases, especially those involving severe or long-standing nerve compression, complete symptom resolution may not be achieved. Although, most patients experience a significant improvement in their symptoms and can return to their normal activities following Carpal Tunnel Release surgery.