When should you consider surgery for carpal tunnel syndrome?

When should you consider surgery for carpal tunnel syndrome?

 

Carpal tunnel syndrome is a condition that affects your hand and is caused by excessive pressure on the median nerve that runs through the wrist. The median nerve goes all the way down our arm into our hand through the carpal tunnel, which is located on the underside of the wrist. The nerve has pretty important functions, like controlling the movement and feeling of our thumbs and fingers, except the little finger. The carpal tunnel provides not only a passage for the median nerve but also allows your fingers to bend properly.

 

However, when the wrist is overworked and the pressure on the median nerve and the tunnel increases, there is a tingling in the hands and some numbness and before you realize it, the entire arm goes into agony and pain and does not allow your hand to function properly. The situation is termed carpal tunnel syndrome.
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Carpal tunnel syndrome is a painful condition. It may appear a minor inconvenience for some individuals who do not experience severe symptoms like pain, numbness, weakness or other symptoms that accompany carpal tunnel syndrome. But the condition can become debilitating for some individuals experiencing severe symptoms and in such cases, the individual may require Wide Dog Collar

A research published by NCBI states that -

Most people with carpal tunnel syndrome only consider having surgery if other treatments don't provide enough relief. Surgery can help relieve symptoms or make them go away for good, but it is not without risks.

Source- https://www.ncbi.nlm.nih.gov/books/NBK279597/

 

Carpal Tunnel Release Surgery

 

If the pressure on the carpal tunnel is mild and the nerve is not damaged much, non-surgical treatment options can be a viable and successful option. But in most cases, carpal tunnel syndrome becomes more severe with time and more activity of the wrist. In situations like this, surgery becomes a more appropriate option. The goal of carpal tunnel release surgery is to relieve the pressure on the median nerve by cutting the ligaments that pass from over the nerve. After the surgery, the ligaments gradually grow back together while making room for the nerve to pass freely.

 

When performed by an adept team of orthopedic surgeons, the median nerve is decompressed successfully, and the internal healing process is completed in a few weeks as well. 

 

Minimally invasive Carpal Tunnel Surgery with Endoscopic approach

Endoscopic carpal tunnel release surgery is an innovative and minimally invasive procedure that uses an endoscope (a thin, specialized device with a camera attached on one end), inserted through a small incision at the wrist. The endoscope lets the surgeon clearly view and directly access the internal structures of the wrist, such as the transverse carpal ligament, making a long incision on the wrist.

During endoscopic carpal tunnel surgery, the carpal ligament is cut, which releases pressure on the median nerve, and relieves the symptoms of carpal tunnel syndrome. The gap where the carpal ligament was cut will eventually fill with scar tissue, while maintaining the sufficient space of the carpal tunnel. Endoscopic carpal tunnel release surgery allows faster recovery and less postoperative pain and discomfort than open carpal tunnel surgery. The procedure is performed under the influence of general or local anesthesia and does not require a long hospital stay. During the recovery process, the Arm Blaster tissues slowly grow back together, with more room for the median nerve.

How effective is Carpal Tunnel Release Surgery?

Each year, over 4,00,000 carpal tunnel surgeries are performed across the world and the prognosis is usually very positive.

Most individuals who undergo carpal tunnel release surgery report to have complete relief from pain, tingling and other symptoms. With regular physiotherapy, most patients regain maximum to full strength of the hand, wrist and fingers that was previously compromised. They also report little to no pain and numbness in their hand and better hand function after complete recovery.

There are a few things that can determine the effectiveness of this surgery. The orthopedic surgeon’s experience is one major factor. To gain maximum benefits from carpal tunnel surgery, it is recommended to choose an experienced and skilled orthopedic surgeon and a trusted healthcare provider.

What nonsurgical treatments should I try for carpal tunnel syndrome before considering surgery?

To decide a proper treatment plan for you, the orthopedic specialist will perform a detailed diagnosis to ensure that the cause of the symptoms is carpal tunnel syndrome and also find out the severity of the condition and how it is affecting the individual’s life. Generally,the  severity of the symptoms guide the treatment. For mild to moderate symptoms, the orthopedic doctor will suggest a number of nonsurgical strategies that may help your hand and wrist feel better. Your orthopedic doctor will tell you which treatment is right for you.

 

 

Nonsurgical treatments and strategies to manage mild to moderate carpal tunnel syndrome

 

       Rest- If you have developed carpal tunnel syndrome due to repetitive use of hand or wrist or stress from a repetitive activity like manual operation of machinery equipment or typing, it may be possible to recover by avoiding those activities for some weeks. Your orthopedic specialist will discuss your daily habits and lifestyle to determine which actions or activities might be straining your wrist, and how to modify them.

       Wearing a wrist brace- Another nonsurgical treatment for mild to moderate carpal tunnel syndrome is wearing a wrist brace or splint.  You can easily get a wrist splint in local medical stores. Follow your orthopedist’s directions regarding how long you should be wearing the splint each day. In some cases, the orthopedic doctor may recommend wearing the wrist splint even while sleeping.

       Steroid injections- An injection of cortisone (a steroid solution), near the carpal tunnel area can help reduce the pain and swelling. These steroid injections can provide immediate pain relief for most patients but some may also experience that a bit later. Some individuals also report no relief at all with steroid injections. If you are interested, your orthopedist will discuss special precautions and potential complications of the injections and whether or not you should consider them.

       Stretching and strengthening- Physiotherapy and exercises can help in improving wrist and forearm mobility. Most individuals with mild to moderate carpal tunnel symptoms find relief with weeks of regular physiotherapy. However, individuals seeking prompt relief should speak to their doctor about surgery.

       Use an ice pack- Use an ice pack for your wrist for 10 -15 minutes. Repeat the same 1 or 2 times every hour if you are having severe pain.

       Keeping the wrist in a neutral position at night- for individuals with more serious symptoms, the doctor may recommend to keep the wrist straight by wearing a wrist splint while sleeping.

       Anti-inflammatory medications can relieve pain and reduce swelling, but should only be taken when prescribed by a doctor.  

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