Carpal tunnel syndrome (CTS) is a disease that causes tingling, numbing and other signs and symptoms in hand. It happens when the nerve in the carpal tunnel is pinched.
In many instances, the pinching of the nerves results from the typical everyday activity that involves repetitive movements of the wrist. These include using vibrating hand tools, writing for long hours, playing a musical instrument and manual labor.
CTS affects the median nerve, which is found the forearm to the palm. The median nerve is responsible for providing feeling to the palm side of the thumb to the index, middle finger and ring finger.
Carpal tunnel syndrome worsens over time. That’s why it is important to identify and diagnose the disease early. The symptoms may be relieved by simple measures during the early stages of -the disease. However, when the disease progresses, it may lead to the inability to do certain activities.
Treating Carpal Tunnel Syndrome (CTS)
Carpal tunnel syndrome can develop slowly and gradually. For some individuals, the condition may become worse over long periods even without treatment. In some cases, they need treatment to provide relief from pain and discomfort.
For mild CTS, non-surgical treatment may be recommended such as:
Splinting or bracing – In some people, wearing a brace or splint at night may help prevent the wrist from bending. If you keep the wrist still or in a neutral position, it reduces the pressure on the median nerve.
Activity changes – The symptoms often worsen or occur when the hand or wrist are placed in the same position for long periods, especially when the wrist is extended or flexed. Make sure you modify or change these activities to slow the progression of the disease.
Nonsteroidal anti-inflammatory drugs (NSAIDs) – Medicines may help relieve pain and inflammation. Examples of NSAIDs include naproxen sodium and ibuprofen.
Corticosteroid injections – Corticosteroid or cortisone can relieve inflammation. This is injected into the carpal tunnel, and it may help relieve pain and swelling.
What is carpal tunnel surgery?
Carpal tunnel surgery opts for more severe cases.
Open surgery for carpal tunnel syndrome
The surgical procedure performed for carpal tunnel syndrome is dubbed as “carpal tunnel release.” In this procedure, the goal is to relieve the pressure on the median nerve by slicing or cutting the ligament that forms the roof of the tunnel.
This procedure can relieve the symptoms and potentially heal the condition. The median nerve and the tendons, which are important for hand movements, pass through a narrow passageway in the carpal tunnel. When this part is injured, inflamed or narrowed, the swollen tissues can press on the median nerve, causing pain, tingling sensation, loss of function and numbness.
What are the risks of carpal tunnel release? As with most surgeries, carpal tunnel release may have risks, too. The common risks include bleeding, injury to the median nerve, injury to the blood vessels, infection and a sensitive scar.
After surgery, the wrist will likely be in a bandage or splint for about two weeks. The doctor will then remove the bandage, and you will be allowed to move the fingers to reduce the chance of stiffness and complications with movements. Pain will still be there, but pain relievers will be given for relief. Also, elevate the arm and hand while sleeping to reduce inflammation.
Endoscopic Carpal Tunnel Surgery
The term endoscopic means that a camera will be used to aid in the surgery. Endoscopic carpal tunnel surgery is a minimally invasive procedure that treats the condition. Unlike carpal tunnel release or open carpal tunnel surgery, the procedure needs only a small incision in the side of the palm, where the endoscope will be inserted.
The procedure involves the insertion of the camera along with small surgical instruments to release the pressure on the median nerve. The procedure, since it’s minimally invasive, has lesser pain, recovery time and restrictions. Furthermore, after the surgery, there is no need for splints. The only restriction is lifting of heavy objects.
Just like open surgery, endoscopic carpal tunnel surgery can have complications, too.
Some of the common complications include reactions to the anesthesia, infection, pain on the surgical site, incomplete ligament release and hand weakness.
In terms of recovery, the patient will usually be scheduled for a follow-up consultation after 10 days. The doctor might need to remove the stitches and examine the hand’s movements Finger motions are safe to start within one day after surgery, but patients are barred from heavy lifting and pinching with the hand for six weeks.
The doctor might recommend seeing a physical therapist to maximize the movement and healing of the hand.
Carpal tunnel syndrome surgery is usually the last resort in treating the condition. There are many options for other treatments, but when all else fail, the doctor might recommend undergoing surgery.