Q & a Carpal Tunnel Syndrome

Q & A

Carpal Tunnel Syndrome

Carpal tunnel syndrome is a neuropathy caused by compression at a nerve called the median nerve that travels within the carpal tunnel located in the area of your palm. This tunnel is small, but it contains nine tendons along with the median nerve. Therefore, any increase in pressure within the tunnel would compress the injury-prone median nerve. The prevalence of carpal tunnel syndrome has been reported to vary between 0.6% to 61% in different occupational groups. Fifty percent of the cases are reported to occur in patients between the ages of 40 and 60 years old. Risk factors for developing carpal tunnel syndrome include but are not limited to repetitive hand work, rheumatoid arthritis, pregnancy, diabetes, trauma, etc.

How do I know that I have carpal tunnel syndrome?

Numbness in the thumb, index, and middle fingers are the predominant complaint in patients with carpal tunnel syndrome. The numbness/pain can radiate to the forearm. These numbness symptoms can wake the patient up at night. In more severe cases, the patient may complain of clumsiness, inability to perform manual tasks effectively, and weakness in grip. Irreversible muscle damage can occur if the nerve compression is left untreated.

What are the treatment options for carpal tunnel syndrome?

Carpal tunnel syndrome can be treated both with surgery and without surgery. Nonoperative therapies consist of use of a wrist splint, steroid injection in some cases, avoiding aggravating activities, and modification of workplace. Surgery is indicated in cases that do not respond to nonoperative means or in cases where the nerve compression is found to be significant. Surgery for carpal tunnel release is usually an outpatient procedure. The procedure is often performed under local anesthetic with the patient under slight sedation. Surgery for carpal tunnel syndrome involves the release of a ligament called the transverse carpal ligament covering the tunnel in order to relieve the nerve of the pressure felt within the tunnel.

What are the risks of surgery?

Surgical risks vary among patients. In general the risks include but are not limited to bleeding which is minimal, infection (0.6%), nerve or vessel damage (less than 1%), painful scar, and anesthetic risks. Because most of these procedures are done under local anesthetic with slight sedation, these risks are low and the potential benefits of surgery outweigh the risks of the procedure. We have an excellent and experienced team of orthopedic surgeons, anesthesiologists, nurse anesthetists, and perioperative nurses who all strive to assure your optimal surgical experience and outcome.

What can I expect during healing?

In general, your wrist is splinted for approximately ten days to two weeks after surgery. Your fingers, however, are free and the patient is encouraged to perform daily finger exercises to minimize the risks of swelling and stiffness. Sutures are removed in approximately two weeks after surgery and at this point, Physical Therapy is consulted for activity modification teaching, hand and wrist range of motion exercises and strengthening, and various modes of therapy aimed at minimizing the development of painful postoperative scars.