When is surgery recommended for carpal tunnel

If that provides only temporary relief, then surgery may be recommended. The carpal tunnel is a small passageway on the palm side of your wrist. Nine tendons and the median nerve travel through the carpal tunnel. Those tendons are like ropes that control the movement of your fingers. The median nerve serves as a pathway for the sensations you feel in your palm, thumb, index finger, middle finger and outer border of your ring finger. It also sends the nerve signals that move muscles around the base of your thumb.

Carpal tunnel syndrome happens when the space in the carpal tunnel becomes smaller or the tendons in the tunnel thicken, placing pressure on the median nerve. In its early stages, symptoms may include tingling or numbness in your thumb, index finger, middle finger and outer border of your ring finger.

A wrist splint typically is the first step in carpal tunnel treatment. A splint can be particularly helpful for people whose symptoms bother them at night. Fitzmaurice and his medical care team has extensive knowledge and expertise in treating carpal tunnel syndrome. In this blog, he shares his knowledge of carpal tunnel to help patients in the Phoenix Metropolitan area and across the country who might need or are considering treatment for carpal tunnel. Research has demonstrated that results after surgery are better if treated earlier than later.

For example, the fingers could weaken until they become unusable. Which is why patients with carpal tunnel are encouraged to seek treatment before their symptoms become debilitating. The goal of performing carpal tunnel surgery is to relieve pressure on the median nerve.

This can be accomplished by cutting or releasing the transverse carpal ligament in the palm of the hand. A successful surgery is not only dependent on cutting this ligament to ensure pressure relief, but also being able to avoid causing harm to nearby structures. 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. For most patients, surgical release and control of environmental factors that may place their wrists in a position of stress will banish their carpal tunnel syndrome.

There are a very small number of patients who need a second surgical procedure to release the carpal tunnel a second time. Patients are encouraged to use their fingers and arm for light activity right after surgery.

I tell my patients to refrain from activities that break a sweat and to not lift anything heavier than a can of soda with their operative hand. Most patients do not need formal hand therapy after surgery, but if recovery is slower than usual, I refer my patients to a hand therapist to help us on the path to wellness.

Your doctor will release the ligament through an incision on the inside of the wrist. The surgery can be performed on an outpatient basis. After two weeks, you can resume other normal activities — except those that put pressure on the palm. Six weeks post-surgery, you should be fully recovered, though you might feel some discomfort during pushups and other strenuous activities.

According to Dr. Lefebvre, this is not because of the recovery of the nerve but rather recovery from the incision. Lefebvre explained.