Should i have carpal tunnel surgery

When performed by an expert hand surgeon, damage to any surrounding tissue can be avoided and will help speed up recovery time. There are two possible procedures when surgery is considered:. In this procedure, a surgeon makes an incision on the inside of the wrist. This will release pressure on the median nerve, relieving the symptoms of carpal tunnel syndrome.

The surgeon will then make an incision on the base of the palm. This opening allows the surgeon to see and cut the transverse carpal ligament. After cutting the ligament and releasing the underlying pressure, the incision is closed with stitches. The cut ligament gap is left open to be eventually filled up with scar tissue.

Open carpal tunnel surgery is performed under local or general anesthesia, depending on the doctor. After surgery, the hand will be wrapped. Patients are discharged the same day and will return in 2 weeks to have stitches removed. Pain and discomfort should subside within weeks.

Invented by Dr. This also means less pain and downtime, plus faster recovery. During the procedure Dr. Fitzmaurice will use a thin, flexible tube endoscope which comes with an attached tiny camera on one end. Using the same incision or the addition of another small one, cutting tools will be inserted. He will then cut the transverse carpal ligament, release pressure from the median nerve and then close the small incisions. The healing of this type of surgery is typically faster than an open carpal tunnel surgery, which debunks some common myths about carpal tunnel treatment and recovery.

There are over , carpal tunnel surgeries performed each year and the prognosis for usually very positive. Activity changes. Symptoms often occur when your hand and wrist are in the same position for too long—particularly when your wrist is flexed or extended. If your job or recreational activities aggravate your symptoms, changing or modifying these activities can help slow or stop progression of the disease.

In some cases, this may involve making changes to your work site or work station. Nerve gliding exercises. Some patients may benefit from exercises that help the median nerve move more freely within the confines of the carpal tunnel. Specific exercises may be recommended by your doctor or therapist.

Steroid injections. Corticosteroid, or cortisone, is a powerful anti-inflammatory agent that can be injected into the carpal tunnel. Although these injections often relieve painful symptoms or help to calm a flare up of symptoms, their effect is sometimes only temporary. A cortisone injection may also be used by your doctor to help diagnose your carpal tunnel syndrome. If nonsurgical treatment does not relieve your symptoms after a period of time, your doctor may recommend surgery.

The decision whether to have surgery is based on the severity of your symptoms—how much pain and numbness you are having in your hand. In long-standing cases with constant numbness and wasting of your thumb muscles, surgery may be recommended to prevent irreversible damage. This increases the size of the tunnel and decreases pressure on the median nerve.

The transverse carpal ligament is cut during carpal tunnel release surgery. When the ligament heals, there is more room for the nerve and tendons. In most cases, carpal tunnel surgery is done on an outpatient basis. The surgery can be done under general anesthesia, which puts you to sleep, or under local anesthesia, which numbs just your hand and arm.

In some cases, you will also be given a light sedative through an intravenous IV line inserted into a vein in your arm. Open carpal tunnel release.

In open surgery, your doctor makes a small incision in the palm of your hand and views the inside of your hand and wrist through this incision. During the procedure, your doctor will divide the transverse carpal ligament the roof of the carpal tunnel. After surgery, the ligament may gradually grow back together—but there will be more space in the carpal tunnel and pressure on the median nerve will be relieved. Endoscopic carpal tunnel release.

In endoscopic surgery, your doctor makes one or two smaller skin incisions—called portals—and uses a miniature camera—an endoscope—to see inside your hand and wrist. A special knife is used to divide the transverse carpal ligament, similar to the open carpal tunnel release procedure.

A cutting instrument will be inserted in the palm. The outcomes of open surgery and endoscopic surgery are similar. There are benefits and potential risks associated with both techniques.

Your doctor will talk with you about which surgical technique is best for you. Immediately following surgery, you will be encouraged to elevate your hand above your heart and move your fingers to reduce swelling and prevent stiffness. You should expect some pain, swelling, and stiffness after your procedure. Minor soreness in your palm may last for several weeks to several months. Grip and pinch strength usually return by about 2 to 3 months after surgery. If the condition of your median nerve was poor before surgery, however, grip and pinch strength may not improve for about 6 to 12 months.

You may have to wear a splint or wrist brace for several weeks. You will, however, be allowed to use your hand for light activities, taking care to avoid significant discomfort. Driving, self-care activities, and light lifting and gripping may be permitted soon after surgery. Your doctor will talk with you about when you will be able to return to work and whether you will have any restrictions on your work activities.

Although complications are possible with any surgery, your doctor will take steps to minimize the risks. The most common complications of carpal tunnel release surgery include:.

For most patients, surgery will improve the symptoms of carpal tunnel syndrome. Get the facts. Your options Have surgery for carpal tunnel syndrome. Don't have surgery. Use rest, ice, medicine, wrist splints, and new ways to do some tasks.

Key points to remember Home treatments may be all you need if you've had mild symptoms for a short time. You may be able to treat carpal tunnel syndrome with rest, ice, medicine, and wrist splints.

You also can learn to do some tasks in a way that doesn't hurt your wrist. Surgery may be a better choice if you've had very bad symptoms for a long time. Surgery for carpal tunnel syndrome may give you only a little relief if your symptoms are caused by other health problems, such as rheumatoid arthritis, hypothyroidism, or diabetes. Treating these problems often makes carpal tunnel symptoms get better or go away. But in some cases, you still might need surgery.

Symptoms of carpal tunnel syndrome in pregnant women often go away after childbirth. Unless your symptoms are very bad, you may want to wait and see if your symptoms go away after you have the baby. What is carpal tunnel syndrome? What problems can you have from carpal tunnel syndrome? You may have: Pain. Weak thumb muscles. This makes it hard for you to grip or hold objects. Loss of feeling and ability to use your fingers and hand well. How does surgery fix carpal tunnel syndrome?

It can be done in one of two ways: Open surgery : Your doctor makes a small cut incision in the palm of your hand.

Endoscopic surgery : Your doctor makes one small incision in the wrist, or one small incision in the wrist and one in the palm. He or she puts a thin tube with a camera attached endoscope into the incision. Surgical tools are put in along with the scope. How well does surgery work? What can you do other than have surgery? You may try to: Rest your hand for 1 or 2 weeks. Stop activities that hurt.

Put ice on the palm of your hand and wrist for 10 to 15 minutes at a time. Studies haven't shown NSAIDs to be effective for carpal tunnel syndrome, but they may help relieve your symptoms. They can cause side effects.

Be safe with medicines. Read and follow all instructions on the label. Change the way you do certain hand motions. Wear a wrist splint. It's usually worn at night, but you can wear it during the day. Other choices You can work with a physiotherapist to learn how to do activities in a new way. If these home care treatments don't help, you may be able to take corticosteroid shots or pills to improve your symptoms. You can try yoga. Unless your symptoms are very bad, you may want to put off having surgery and see if your symptoms go away after you have the baby.

How well do other treatments help symptoms? Splints are easy and inexpensive, and there is little risk to trying them. Corticosteroid shots and pills give short-term relief from symptoms.

Why might your doctor recommend surgery for carpal tunnel syndrome? Your doctor might recommend surgery if: You've had very bad symptoms for a long time, so you're at risk of having lasting nerve damage.

Test show that you have nerve damage. A wrist splint, medicines, and other treatments haven't helped your symptoms. Compare your options. Compare Option 1 Have surgery for carpal tunnel syndrome Try other treatments. Compare Option 2 Have surgery for carpal tunnel syndrome Try other treatments.

Have surgery for carpal tunnel syndrome Have surgery for carpal tunnel syndrome You have local anesthetic, so you are awake but won't have pain. You go home on the same day.

You need to avoid heavy use of your hand for up to 3 months. If you have open surgery on your dominant hand and you do repeated actions at work, you may be able to return to work in 6 to 8 weeks. If the surgery is on the other hand and you do not do repeated actions at work, you may be able to return to work in 7 to 14 days.

If you have endoscopic surgery, you may be able to return to work sooner than with open surgery. Surgery can make symptoms get better or go away for most people. It can prevent lasting nerve damage. Surgery doesn't always help. Your symptoms may come back. Major problems from surgery, such as infection or a problem from anesthesia, are rare. Try other treatments Try other treatments You can try several home treatments to ease symptoms of carpal tunnel syndrome, including: Rest.

A wrist splint. New ways of doing tasks. You may get corticosteroids. If you are pregnant, you can wait to see if the problem goes away after childbirth. You don't have the risks of surgery. You may not have to take time off from work. You don't have the expense of surgery.

Other treatments might not work. If you have very bad symptoms and wait too long, you could have lasting nerve damage. Temporary increase in pain, or a small chance of nerve damage, after a corticosteroid shot. Personal stories about surgery for carpal tunnel syndrome These stories are based on information gathered from health professionals and consumers.