Carpal tunnel syndrome (CTS) is a debilitating medical condition involving the median nerve and a small structure in your wrist called the carpal tunnel. Providing sensation to the thumb and the middle and index fingers, the median nerve extends down from your upper arm, through the carpal tunnel and into your fingers. The carpal tunnel is composed of numerous tiny bones, ligaments and tendons that swell when irritated due to repetitive motions. Compression of the median nerve by the carpal tunnel when it swells is the primary cause of CTS.
Risk Factors for Carpal Tunnel Syndrome
- Trauma to the wrist (a break or bad sprain can trigger CTS symptoms)
- Engaging in work or hobbies that require repetitive wrist and hand motions
- Rheumatoid arthritis and other inflammatory diseases
- Osteoarthritis of the wrist
- Insulin use
- Obesity
Nonsurgical CTS treatments for reducing radiating pain, tingling and numbness in the fingers, hands and wrists typically include:
- Avoiding repetitive motions that worsen pain
- Taking over-the-counter or prescription anti-inflammatory medications
- Wearing wrist splints or other wrist support devices
- Having corticosteroids injected into the carpal tunnel area
How do you know if it is time to consider carpal tunnel release (CTR) surgery? Doctors recommend CTR surgery when pain does not respond to standard treatments and you can no longer perform daily tasks due to worsening numbness and pain. Additionally, if the median nerve remains compressed too long, it may become damaged permanently and lead to muscle atrophy in the wrist and fingers.
What is Carpal Tunnel Release Surgery?
An outpatient procedure that relieves pressure on the median nerve, carpal tunnel release surgery involves a surgeon making one or two small incisions in the palm side of the wrist. Once the incision is made, the surgeon cuts the ligament covering the tunnel. By “releasing” the ligament in this way, CTR surgery significantly reduces compression of the medial nerve.
In some cases, CTR may be done as an endoscopic procedure. Endoscopy is a broad term describing any type of minimally invasive surgery that utilizes the insertion of a tiny camera into an area of the body. During an endoscopic CTR, the surgeon is able to see details of the median nerve and carpal tunnel to determine if additional procedures are needed.
Once you are scheduled for CTR surgery, your doctor will ask you to:
- Stop taking blood thinners temporarily if you take them. This includes ibuprofen, aspirin or other drugs that can thin the blood and promote bleeding.
- Avoid taking certain nutritional or herbal supplements several days before surgery. If you take supplements, tell your doctor what kind of supplements they are and how long you have been taking them.
- Avoid smoking a few days before CTR surgery. Nicotine and chemicals in tobacco smoke can slow the healing process.
- Let your doctor know if you don’t feel well a day or two before surgery, especially if you have a fever.
Patients are given general anesthesia or twilight anesthesia before surgery. Carpal tunnel release surgery generally takes about one hour to complete.
Recovering from Carpal Tunnel Release Surgery
Following a few hours in a recovery room, you will be released to return home the same day as the surgery. You will have to wear a splint to stabilize your wrist for a week to 10 days. Keep the splint dry and clean until your doctor removes it, most likely during your first follow-up visit. Stitches will also be removed at this time if they are not dissolvable stitches.
Once you no longer need the splint, you can start doing strengthening exercises at home or begin a physical therapy program. Be aware that recovery after CTR surgery is different for everyone. People with severe carpal tunnel symptoms will naturally take longer to regain their wrist and hand strength than people with moderate CTS symptoms. Age and health are two other factors that could influence the recovery process.
While your wrist is healing from carpal tunnel release surgery, it is normal to experience some pain, stiffness and swelling. Your grip will continue to be weak for at least four to six weeks, but you should be able to grip and hold lightweight objects.
It is possible you could return to work within three weeks, depending on the type of job you have. Light duty tasks are recommended until you regain most of your wrist and hand strength.
How Successful is Carpal Tunnel Release Surgery?
Studies show that CTR surgery offers significant improvement involving pain reduction, grip strength and sensation in the hand and fingers. Complications such as bleeding, permanent soreness of the incision site and infection are rare and should not prevent you from considering carpal tunnel release surgery.
If you are suffering from carpal tunnel syndrome and have not found relief from noninvasive treatments, call Southern Coast Spine & Pain Specialists today to learn more about carpal tunnel release surgery.