Carpal tunnel release
Carpal tunnel syndrome occurs when the median nerve is compressed at the wrist. This common condition causes tingling or numbness of the thumb, index and middle fingers, and palm of the hand. This is usually noticed first at night, but may occur during the day, particularly with repetitive movements and certain hand positions. It may also case weakness of the hand and difficulty with fiddly tasks such as doing up buttons. One or both hands may be affected, and symptoms do tend to worsen gradually over time.
CARPAL TUNNEL RELEASE/ DECOMPRESSION
Type of anaesthetic
Length of surgery
Nights in hospital
0 nights (day case)
In some cases, I will recommend that nerve conduction studies are carried out prior to making a decision to operate. This test is useful to confirm the diagnosis, although it may not always be necessary. Carpal tunnel syndrome may occasionally be associated with other conditions, such as an underactive thyroid, pregnancy, arthritis, or others. Certain other tests may therefore be warranted, and I will discuss this with you at your consultation.
Wearing a wrist splint may be very helpful, particularly if the symptoms are relatively mild, or if the condition is expected to settle (for example cases occurring during pregnancy). A steroid injection to the wrist area can be effective, and again is useful in milder cases, or where there is a wish to defer or avoid surgery. Repeated treatments are usually required.
Generally speaking, surgical decompression is the treatment of choice for carpal tunnel syndrome. It physically removes the pressure from the nerve, and offers the possibility of complete relief from symptoms. As a rule, tingling can be expected to resolve completely following surgery. If the condition has progressed to a point where there is constant numbness or any weakness, these may improve, but it is unlikely that they will completely resolve. Thus, I usually recommend operating before this point is reached.
The procedure is usually carried out under local anaesthetic, as a day case, and is very well tolerated. An incision is made from the wrist onto the palm of the hand, and the tight tissue overlying the nerve released. Great care is taken to avoid damaging the nerve or other nearby structures. There are stitches in the skin, which are removed after about 2 weeks. It is important to keep your hand moving from the very first day, in order to prevent stiffness. Once your stitches are removed and the wound healed, you will be encouraged to start scar massage in order to encourage healing, and to reduce the chance of pain in the scar, which is a problem for a small number of patients undergoing this procedure.
Your occupation, hobbies, and certain other factors will determine the amount of time you will need off work and your overall recovery time. This will be discussed with you at the time of your consultation