Carpal tunnel syndrome occurs when the main nerve (the median nerve) passing through your wrist to your hand becomes compressed or squeezed, resulting in pain, tingling, numbness and loss of muscle coordination in your fingers and palm. Sometimes, these symptoms can be relieved with splinting or other noninvasive techniques. But when these approaches don’t provide effective, long-lasting relief, carpal tunnel surgery might be a good option.What is carpal tunnel surgery?Carpal tunnel surgery focuses on relieving the pressure inside the carpal tunnel, a narrow channel that provides a pathway for the median nerve as it travels through the wrist to the hand. During the procedure, the surgeon releases the transverse carpal ligament, a strong band of fibrous tissue that covers the palm side of the carpal tunnel. (That’s why sometimes you may hear carpal tunnel surgery referred to as carpal tunnel release.) Releasing the ligament expands the space inside the carpal tunnel to relieve compression on the median nerve.
How is the surgery performed?There are two basic approaches to carpal tunnel release surgery:Endoscopic surgery uses one or two very small incisions near your wrist to release the ligament. During the procedure, the surgeon inserts a thin, flexible scope through the incision. The scope is equipped with a tiny camera that sends detailed, real-time video to a monitor, allowing the surgeon to see the area “close up” without the need for a larger incision.
This technique also uses special surgical instruments designed to be used through small incisions. In the single-incision approach, the instruments and camera are both contained on the same scope. When two incisions are used, the camera will be inserted through one incision while the instruments are inserted through the second incision.Open surgery is the traditional approach to carpal tunnel release, and it relies on a single, larger incision in your wrist.Both types of carpal tunnel surgery usually are performed on an outpatient basis, which means you can go home shortly after your procedure, and both take about a half hour to perform.
Most surgery is performed using sedation to help you sleep throughout your procedure, along with a numbing agent that’s injected into your wrist and palm areas. The sedative is administered through an IV in your arm.What happens after the surgery?After surgery, a dressing and special splint will be applied to your wrist to protect and keep it stable during the very early stages of healing. You’ll spend a little time in a recovery area where you’ll be monitored before being discharged.
You’ll need to have someone drive you home, and you won’t be able to drive for 24 hours after your procedure. You’ll also need to avoid heavy use of your hand for a few weeks as the area heals. Before being discharged, you’ll receive complete instructions regarding how to care for the area and what types of activities you can perform. After a week or so, you’ll start performing gentle stretching exercises to keep the joint flexible and to promote circulation and healing.When can I return to work?That depends on the surgical approach that was used, as well as how much you use your hand at your place of employment.
Some people can return to work within one or two weeks, while others may not be able to return for six to eight weeks.How can I tell if carpal tunnel surgery is a good choice for me?Carpal tunnel surgery typically is performed after other methods, like splinting, corticosteroid injections and habit changes, fail to provide relief. Left untreated, carpal tunnel syndrome can weaken your grip and make it difficult to perform activities that require your fingers, like writing or even buttoning a shirt. If you’re suffering from carpal tunnel syndrome and your symptoms haven’t resolved, call Franklin Orthopaedics and Sports Medicine at (615) 771-1116 and schedule an evaluation today.