Carpal tunnel syndrome is a condition caused by a pinched nerve in the wrist. Symptoms of carpal tunnel include persistent tingling as well as numbness and radiating pain in the arms and hands. In some cases, you may also experience hand weakness.
This condition can begin slowly and gradually progress. Pressure on the median nerve, which runs from the forearm to the hands, triggers carpal tunnel pain. Carpal tunnel release is a surgery that helps reduce pressure on this nerve and treat carpal tunnel symptoms.
Carpal tunnel release surgery is not for everyone. In fact, some people are able to treat their carpal tunnel symptoms with nonsurgical methods. You can take over-the-counter anti-inflammatory drugs, such as ibuprofen or aspirin, or prescription pain medications. Doctors may recommend a steroid injection and inject medication directly into your arm or hand.
Other types of nonsurgical methods include:
- cold or ice compress
- splints to keep the wrist straight so that there is less tension on the nerve
- physical therapy
Repetitive activities, such as typing, can also trigger or worsen carpal tunnel syndrome. Taking frequent breaks and resting your hands can reduce symptoms and alleviate the need for a surgical procedure.
However, if pain, numbness, or weakness continues or worsens even after experimenting with nonsurgical methods, your doctor may recommend carpal tunnel release. Before scheduling your procedure, your doctor may perform a nerve conduction test and electromyogram (EMG) test to check for abnormal muscle electrical activity, which is common in carpal tunnel syndrome.
Tell your doctor about all the medicines and supplements you’re currently taking. Your doctor may instruct you to stop taking some of your medications (aspirin, ibuprofen, and blood thinners) one week before your scheduled surgery. Tell your doctor if you’re experiencing any illnesses, such as cold, fever, or virus before surgery. Have someone drive you to the hospital and arrange for a ride back home. Do not eat for six to 12 hours before carpal tunnel release surgery.
There are two ways to perform carpal tunnel release: open carpal tunnel release and endoscopic carpal tunnel release.
Open carpal tunnel release
Your surgeon makes a small cut near the lower section of your palm near your wrist. The surgeon then cuts the carpal ligament, which reduces pressure on your median nerve. Depending on your case, the surgeon may also remove tissue from around the nerve. The surgeon applies a few stitches to close the wound and then covers the area with a bandage.
Endoscopic carpal tunnel release
The surgeon makes a small cut near the lower section of your palm near your wrist. The surgeon then inserts an endoscope into your wrist. An endoscope is a long, flexible tube with an attached light and camera. The camera takes video from inside your wrist and these images appear on a monitor inside the operating room. Your surgeon will insert other tools through this opening and cut the carpal ligament to reduce pressure on your nerve. The surgeon removes the tools and endoscope and then closes the incision with a stitch.
This outpatient procedure takes about 15 to 60 minutes. You will receive anesthesia before the procedure. Anesthesia will cause you to fall asleep and prevent pain during the procedure. You may experience some pain or discomfort after the anesthesia wears off. However, your doctor can prescribe medication to dull the pain.
Risks associated with this type of surgery include:
- nerve damage
- allergic reaction to anesthesia or pain medication
Your doctor will schedule a follow-up appointment after surgery to remove your stitches and monitor your progress. However, you should contact your doctor or seek immediate medical attention if you experience any of the following symptoms:
- fever and chills (signs of an infection)
- unusual swelling or redness
- discharge from the surgery site
- intense pain that does not respond to medication
- shortness of breath or chest pains
- nausea or vomiting
Your surgeon will apply a bandage or splint to protect your hand and arm after surgery.
While the surgery quickly relieves pain and numbness, it takes at least four weeks to recover. Here are a few things that you can do after surgery to help your recovery:
- Take your pain medication as directed by your doctor.
- Apply an ice compress to your hand and wrist every few hours for 20 minutes.
- Listen to your doctor’s instructions regarding baths and showers.
- Do not lift heavy objects.
- Elevate your hand for the first few days to reduce swelling and pain.
The first week after the procedure, you will most likely have to wear a splint or bandage of some kind. You may have to undergo physical therapy or carry out special arm exercises in the weeks following the procedure. Recovery time will depend on the amount of accumulated damage there was to the median nerve. Although most people benefit extensively from this surgery, certain symptoms may remain, depending on your condition prior to surgery.