What is Carpal Tunnel Release?

Carpal tunnel release is a kind of surgical procedure to lessen pressure on the median nerve in the wrist.

Effects of Carpal Tunnel Release

This procedure can help those who have carpal tunnel syndrome to develop strength and minimize pain. The carpal tunnel release surgery is more effective in resolving pain and nerve tingling/numbness than muscle weakness.

Candidates for Carpal Tunnel Release

This procedure is ideal for people who have carpal tunnel syndrome that is brought about by pressure on the median nerve. This syndrome may happen when people make use of their hands and wrists in the same way constantly. Moreover, it may occur as the outcome of several illnesses such as rheumatoid arthritis

The fact is women are three times more probable to acquire carpal tunnel syndrome than men. This may be so since the carpal tunnel itself may be smaller in women compared with men. The dominant hand is frequently involved first and produces the most serious pain. Persons that have diabetes or other metabolic disorders that directly affect the body’s nerves and make them more vulnerable to compression are at high risk as well. Typically, carpal tunnel syndrome takes place only in adults.

Your Consultation

Prior to surgery, the doctor will perform a physical exam, focused on strength and sensation in the affected hand or hands. Nerve conduction studies will also be done. These will measure the ability of the nerve to send impulses to the muscles of the thumb. Other tests that may be carried out are Electromyogram (a recording of the electrical currents generated in an active muscle) and MRI scan (a test that uses magnetic waves to make pictures of the inside of the body).

The Carpal Tunnel Release Procedure

Surgery is completed using local anesthesia and does not necessitate an overnight hospital stay. A majority of patients require surgery on both hands. Below are two types of carpal tunnel release surgery:

Open release surgeryis the traditional procedure employed to remedy carpal tunnel syndrome. This approach consists of creating an incision up to 2 inches in the wrist and then cutting the carpal ligament to widen the carpal tunnel. In general, the procedure is carried out under local anesthesia on an outpatient basis, unless there are significant medical considerations.

Endoscopic surgeryis the modern method that may allow more rapid functional recovery and less post-operative discomfort compared to traditional open release surgery. In this approach, the surgeon makes two incisions (about ½” each) in the wrist and palm, then inserts a camera attached to a tube, examines the tissue on a screen, and cuts the carpal ligament (the tissue that holds joints together). This two-portal endoscopic surgery, normally carried out under local anesthesia, is efficient and reduces scarring and scar tenderness, if any. One-portal endoscopic surgery for carpal tunnel syndrome is also available.

Recovery

More often than not, this surgery is done without the need for hospital stay. Total recovery can take anywhere from a number of weeks to a year, depending on the severity of damage to the nerve. A splint may be utilized to lower wrist motion for the first few days following surgery; however, motion should not be postponed for too long because the wrist can turn out to be stiff. The longer the symptoms persist before surgery and the more severely damaged the nerve becomes visible at surgery, the longer the recovery time.

Risks

Anesthesia risks may bring allergic reactions to medications and problems with breathing. As with any other surgery, there may be the risk of bleeding and infection. Other risks specific to carpal tunnel release are injury to the median nerve or its branches, failure of the surgery to develop symptoms, and injury to another nerve or vascular structure (artery or vein).

FAQs

What is carpal tunnel syndrome?

Carpal tunnel syndrome can be brought about by compression of the median nerve at the wrist, which can advance to pain and weakness in the hand. The median nerve is the nerve that provides sensation to the thumb, first two fingers, part of the third finger, and also to several muscles of the hand.

What are the symptoms of carpal tunnel syndrome?

Symptoms typically begin increasingly with recurrent burning, tingling or itching numbness in the palm of the hand and the fingers, particularly the thumb and the index and middle fingers. Some people who suffer carpal tunnel say their fingers feel ineffective and swollen, even if little or no swelling is obvious. At the outset, the symptoms often emerge in one or both hands throughout the night. This is because a lot of people sleep with flexed wrists. A person suspected to have carpal tunnel syndrome may wake up feeling the desire to “shake out” the hand or wrist. As symptoms get worse, people might feel tingling all through the day. Diminished grip strength may make it hard to form a fist, grasp small objects, or carry out other manual tasks. In chronic and/or untreated cases, the muscles at the base of the thumb may wither. Also, some people are not capable of telling between hot and cold by touch.

What are the indications for carpal tunnel release?

Patients who demonstrate symptoms related with carpal tunnel syndrome generally undertake non-surgical treatment first. This consists of anti-inflammatory medications, wrist splints, occupational therapy and workplace modification. Should this fall short to recuperate symptoms, an injection of steroids into the carpal tunnel may be beneficial. Still, if all treatments are unsuccessful, a majority of surgeons will utilize an EMG to test the electrical activity of the median nerve. If the outcome of the test is consistent with carpal tunnel syndrome, then carpal tunnel release surgery will be the last resort.

What causes carpal tunnel syndrome?

Carpal tunnel syndrome can occur in predisposed individuals from a growth in pressure in the carpal tunnel. The growth in pressure may be less important to enlargement or hypertrophy of the synovium surrounding the flexor tendons. This can happen as a response to recurring manual activity or from synovitis associated with a rheumatological condition such as rheumatoid arthritis.

Is the procedure painful?

Anesthesia rules out pain throughout the procedure, but as soon as the anesthesia subsides, you will feel some pain and tenderness in the area of the incision(s).

What should I expect after surgery?

You may be asked to wear a brace or splint for a number of weeks subsequent to surgery. Total recovery may last four weeks or longer. Nevertheless, the numbness or tingling in your hand and fingers should recover relatively quickly. Gradually, your grasp strength will start to get better. You may be given special exercises or may be recommended to attend physical therapy in order to further develop the strength and mobility of your hand and fingers.