Carpal Tunnel Syndrome is characterized by discomfort in the hand resulting from pressure on the median nerve in the wrist. This nerve, along with tendons responsible for finger flexion, traverses a narrow passage called the carpal tunnel. Prolonged repetitive motion, like typing or sewing, can lead to pressure on this nerve, causing swelling within the tunnel. Common symptoms include numbness, tingling, pain, and grip weakness, often worsening at night.

How is Carpal Tunnel Syndrome Diagnosed?

Diagnosis typically involves a clinical examination and tests to confirm that symptoms result from carpal tunnel. Electromyograms (EMG) test the electrical activity of the median nerve and can help pinpoint the condition.

Treatment Options Before Surgery

Before considering surgery, patients often explore non-surgical treatments. These may encompass:

• Anti-inflammatory medications
• Therapeutic exercises and stretches
• Ergonomic workplace modifications
• Wrist splints
• Corticosteroid injections into the carpal tunnel

If conservative treatments prove ineffective, an EMG may be recommended to confirm the diagnosis, after which carpal tunnel release surgery can be considered.

The Carpal Tunnel Release Procedure

The aim of carpal tunnel release surgery is to relieve pressure on the median nerve. The surgery entails:

• Administering local anesthesia with optional sedation for relaxation
• Making a surgical incision in the palm near the wrist
• Cutting the carpal ligament, thereby freeing up space for the median nerve and tendons
• Possible removal of surrounding tissue for further relief
• Closure of the incision with sutures

Some surgeons employ endoscopic techniques, using a camera to guide the procedure through smaller incisions.

Why Opt for Surgery?

When non-surgical methods fail to alleviate symptoms, or if there’s evident muscle wasting due to nerve compression, carpal tunnel release surgery becomes a recommended option.

Potential Risks

As with any surgical procedure, there are potential risks involved:

• Adverse reactions to anesthesia or medication
• Bleeding or infection
• Median nerve or its branches getting injured
• Residual numbness or weakness around the hand
• Rarely, injury to adjacent nerves or blood vessels
• Scar sensitivity

Preparing for the Procedure

Before undergoing surgery:

• Inform the surgeon about all medications, supplements, and over-the-counter drugs being taken.
• Some blood-thinning medications might need to be paused.
• Smoking cessation is recommended as it can impede healing.
• Notify the surgical team of any illnesses, as it may require rescheduling.

Post-operative Care

Post-surgery, a splint or bandage may be applied to the wrist for about a week. Following its removal, motion exercises or hand therapy is usually recommended to aid recovery.

Outcomes and Prognosis

Carpal tunnel release surgery is generally effective in alleviating pain, tingling, numbness, and improving muscle strength. Recovery time varies based on the severity and duration of pre-operative symptoms. It’s noteworthy that patients with prolonged symptoms might still experience some residual discomfort post-recovery.

For a comprehensive evaluation and personalized treatment options, consider scheduling an appointment with Dr. BSV Raju.