Carpal tunnel release
Carpal tunnel release is a surgical procedure used to treat carpal tunnel syndrome, a painful condition caused by the compression of the median nerve in the wrist. The median nerve runs through the carpal tunnel and connects with the thumb and fingers of your hand to provide feeling in the thumb, index, middle, and ring fingers and motion in the muscles at the base of the thumb in the palm. This compression is a direct result of the tightening of the band of tissue where the palm meets the wrist. Carpal tunnel release surgery severs the band of tissue to reduce the excess pressure on the median nerve. This surgery has a high success rate and most patients experience full recovery within a month after the procedure.
One of the most common surgical procedures in the country, carpal tunnel surgery is usually recommended if nonsurgical treatments and exercises bring little or no relief. If the muscles in your hand and wrist are getting smaller as a result of the pinched median nerve, carpal tunnel release surgery usually will be done immediately. The surgeon can perform an electrodiagnostic study, also known as a nerve conduction study (NCS) and an EMG diagnostic test (electromyogram), to detect abnormal nerve and muscle function and determine the severity of your condition.
Before recommending carpal tunnel surgery, your doctor will most likely suggest other carpal tunnel treatments or exercises to relieve any swelling, pressure or pain. Treatments can include:
- Rest – Initial treatment usually consists of resting your hand and wrist while immobilizing your wrist in a splint for at least two weeks. You should also avoid activities that can further irritate the affected areas.
- Splint – Wearing a splint that holds your wrist in a neutral or straight out position at night is usually the most effective treatment to control carpal tunnel symptoms, especially the numbness, tingling and pain that occur at night or when waking up in the morning. Many patients can avoid surgery by using just this simple treatment alone.
- Anti-inflammatory drugs – Aspirin, ibuprofen and other nonprescription painkillers can ease the pain.
- Steroid injections – These treatments ease swelling and pressure on the median nerve.
- Vitamin B6 – This vitamin has been reported to relieve some symptoms of carpal tunnel syndrome.
- Exercise – Stretching and strengthening exercises can be helpful if your symptoms have significantly decreased. A physical therapist will sometimes oversee these exercises or can teach you how to perform them on your own.
After surgery, your wrist may be wrapped in a large dressing to protect the area. Your ability to use your hand can be limited because of soreness in the area and weakness and pain during gripping and holding activities. Exercising the fingers is important to prevent stiffness. Most doctors encourage patients to increase use of their hand and fingers as the pain subsides and the strength returns. Your surgeon may prescribe pain medication to control moderate post-surgery pain. Some patients may require hand therapy to help with the recovery of function and strength.
Some patients recover quickly enough to start to use a computer and drive within a day or two after the operation. It can take a few months before you would be able to do heavy lifting, participate in strenuous sports or even be able to use a manual can opener. Different patients recover at different speeds. Your length of recovery time frequently depends on the severity of your condition prior to surgery.