Carpal tunnel syndrome and decompression surgery
Carpal tunnel syndrome is a common condition that causes pain, numbness, and tingling in the hand and arm. Carpal tunnel syndrome occurs when the tunnel becomes narrowed or when tissues surrounding the flexor tendons swell, putting pressure on the median nerve. In most patients, carpal tunnel syndrome gets worse over time, so early diagnosis and treatment ( Carpal tunnel release surgery ) are important. In most cases carpal tunnel surgery is done as a day case. The surgery can be done under local anesthesia or under general anesthesia.
Carpal tunnel decompression SURGERY – facts
| Length of surgery | 30 minutes |
| Anaesthesia | Local anaesthetic |
| Hospital stay | Day case |
| Risks/complications of surgery | Frequent: Swelling, stiffness, discomfort on movement Infrequent: Infection, bleeding (haematoma), delayed wound healing, painful scar, damage to the nerve, recurrence, incomplete resolution of symptoms, complex regional pain syndrome, triggering |
| Recovery | 1-2 weeks until return to work |
| Driving | 2 weeks |
| Hand position | Elevation above the heart level |
| Follow up | 1 week, 6 weeks, 3 months, 6 months |
| Duration of results | Permanent but depending on severity |
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Carpal Tunnel Decompression
Any hand surgery procedure is a personal choice and understandably there are a number of questions that arise. This information sheet is a general guide for patients considering carpal tunnel syndrome treatment under the care of Dr Mackenzie. It should provide the answers to some questions that you may have.
What is carpal tunnel syndrome?
Carpal tunnel syndrome is a set of symptoms (e.g. “pins and needles”, numbness, weakness) that are caused by compression of the median nerve at the wrist. The median nerve supplies sensation to the thumb, index, middle and inner part of the ring finger. Early on, symptoms can often be relieved with simple measures like wearing a wrist splint or avoiding certain activities. If pressure on the median nerve continues, it can lead to nerve damage and worsening symptoms. To prevent permanent damage, surgery to take pressure off the median nerve may be recommended for some patients ( open carpal tunnel release by division of transverse carpal ligament ).
How is carpal tunnel syndrome diagnosed?
Dr Mackenzie will take a detailed history including complete medical history, how the hands have been used, and any prior injuries. That will be followed by examination of the hand and wrist. An x-ray may be taken to check for arthritis or a fracture. In some cases, laboratory tests may be done. Electrodiagnostic studies will be requested to confirm the diagnosis, check for other possible nerve problems and determine how well the median nerve itself is working and how well it controls muscle movement.
What are the symptoms of carpal tunnel syndrome?
Symptoms usually begin slowly and can occur at any time. They may include:
- Numbness, tingling, burning, and pain—primarily in the thumb and index, middle, and ring fingers
- Tingling is often worse at night or first thing in the morning. It may be provoked by activities that involve gripping an object, for example a mobile telephone or newspaper, especially if the hand is elevated
- Occasional shock-like sensations that radiate to the thumb and index, middle, and ring fingers
- Pain or tingling that may travel up the forearm toward the shoulder
- Weakness and clumsiness in the hand—this may make it difficult to perform fine movements such as buttoning your clothes
- Dropping things—due to weakness, numbness, or a loss of proprioception (awareness of where your hand is in space)