Our hands and wrists are in constant use throughout the day, making them susceptible to a number of injuries and conditions. Carpal tunnel syndrome is a common condition that occurs when pressure is put on the median nerve that runs along a passageway in the wrist (called the carpal tunnel). It can make normal day to day activities painful and difficult. While some symptoms may be alleviated with medications, wrist braces, and other non-surgical treatments, surgery may be required in severe cases of carpal tunnel syndrome.
Carpal Tunnel Syndrome
The median nerve carries information from the brain, including sensation and muscle movement, to the hand and forearm (and vice versa). If the nerve becomes compressed or entrapped, such as from an overuse injury, it can’t function properly. This can trigger symptoms including pain, numbness, weakness, and tingling in the hand, fingers, and arm. Over time, the condition can weaken the muscles in the hand and wrist, and if the condition doesn’t improve with non-surgical treatments or continues to get worse, surgery could be recommended.
Carpal Tunnel Release Surgery
Carpal tunnel release surgery is performed to take pressure off the median nerve to relieve symptoms. There are two main types of surgery – your surgeon can help you decide which option is best for you.
Carpal Tunnel Open Release Surgery involves the surgeon making an incision along the palm, which gives access to the transverse carpal ligament (the roof of the carpal tunnel). The surgeon makes an incision in the ligament to open the tunnel and enlarge it, which takes pressure off of the median nerve.
Endoscopic Carpal Tunnel Release Surgery is also performed to open the carpal tunnel and make it larger, but it requires smaller incisions than open release surgery. It is carried out using an endoscope – a small device with a light and a lens that allows the surgeon to view the carpal tunnel without disturbing nearby tissue. It is often used in conjunction with a camera or video system. A small incision is made below the crease of the wrist, the endoscope is then inserted to view the carpal tunnel. A second small incision may also be required in the palm of the hand. Like open release surgery, this method takes pressure off of the median nerve, but because the procedure is less invasive, it spares nearby tissue, meaning patients can heal faster and experience less discomfort.
Recovering From Surgery
Following surgery, the incision site is wrapped in a soft dressing and a splint may be recommended to provide support and promote healing. Pain relief medication may also be required to alleviate any pain, swelling, and stiffness felt from surgery. Your hand may hurt, feel weak, and be numb initially, but this will improve over the coming days.
Gradually, normal activities can be resumed, such as driving (a couple of days after surgery), and writing (after a week), but pinching motions, lifting, and heavy grasping will need to be avoided for about six weeks. Complete healing from surgery can take much longer.
If open surgery is carried out in your dominant hand and you use repetitive hand actions at work such as typing or assembly line work, you may be unable to return to work for up to 8 weeks. But if surgery is carried out on the other hand, or you do not carry out repetitive hand actions, you may be able to return to work much earlier. Your doctor will be able to advise you on when you can expect to return to work and what activities are off limits during the healing process.
Occupational or physical therapy can help to speed up the healing process and is recommended following surgery to improve strength, joint stability, and coordination. It can take a few months for strength in the wrist and hand to return to normal.
Everyone responds differently to surgery and recovery from carpal tunnel release surgery varies depending on the extent of the condition and the type of surgery performed as well as your overall health. Your doctor will be able to advise you on what to expect.
Full Orthopedic Care in Watertown, New York
If you are suffering with hand or wrist pain or any other orthopedic condition, talk to our multi-specialty medical team at North Country Orthopaedic Group. We diagnose and treat a full spectrum of orthopedic injuries and conditions.