Carpal tunnel surgery
Carpal tunnel syndrome is also referred to as repetitive stress injury and it is estimated that in excess of 500,000 people in the US alone undergo carpal tunnel surgery every year. This is, without doubt, the most common hand surgery implemented each year. Following various trials it is believed that approximately 70% to 90% of all patients who underwent carpal tunnel surgery were free of night-time pain afterwards.
There are various forms of evidence that strongly suggest that carpal tunnel surgery is a far more effective approach than many of the more conservative methods. However, this can still be an extremely troubling decision for potential patients. Electro-diagnostic tests are typically used to confirm the presence of carpal tunnel syndrome however this is not an effective method in determining whether a patient should undergo surgery.
There are certain factors to take into consideration as to whether a patient will respond well to carpal tunnel surgery as opposed to a far more conservative treatment. Those who are more likely to benefit from surgery will include:
- People who have suffered symptoms for a period of 10 months or longer
- Those who have noticed that the muscles in the base of their palm are beginning to shrink
- Those who feel continual numbness
- Those who are aged 50 or above
Unfortunately carpal tunnel surgery will not cure all patients. You may even find that you even lose some of your wrist strength because the carpal ligament has been permanently severed. However only in the rarest cases will this have an effect on the overall function of your hand. Numerous experts actually believe that surgery is performed far too often, when a more aggressive, but conservative treatment may well suffice. These include splints, anti-inflammatory agents, and physical therapy. Carpal tunnel surgery should always be considered a last resort. With that being said, many other experts believe that carpal tunnel syndrome will progress and worsen over time without the use of surgery. There have, in fact, been various tests and indeed evidence that proves that surgery is far better than splints and many other conservative treatments for relieving pain.
There are many factors to consider in order for surgery to be successful. These include that you should be in general good health, surgery should be performed within three years of the diagnosis of this disorder, your symptoms are worse at night than during the day, and you should also be able to produce some form of muscle strength prior to surgery. There are also factors to consider that may reduce the chances of success after surgery. These include those who suffer extreme and severe symptoms prior to surgery, those who perform any manual labour and in particular work with vibrating tools. Patients who abuse alcohol can be negatively affected by carpal tunnel surgery, those who suffer from poor mental health and patients who suffer from diabetes and high blood pressure may even require a second operation.
The standard release surgical procedure for carpal tunnel syndrome is open release surgery. During this procedure, the carpal ligament will be cut free and released from the median nerve. The nerve can then be considered relieved and in actual fact this will surgery is pretty straightforward. Many surgeons have adopted the mini open approach in more recent years. This operation will require a 1 inch incision that is typically viewed via a monitor. The results were generally considered the same as open release surgery however the recovery time is generally shorter. The final form of surgery for carpal tunnel syndrome is an endoscopy. This is a far less evasive procedure than the standard open release. Typically one or two half inch incisions will be made in the wrist and the palm and a surgeon will insert either one or two endoscopes. A tiny camera and a knife will then be inserted through the endoscopes, and while the surgeon views the underside of the carpal ligament on a screen, they have the ability to cut the ligament and free the compressed median nerve.
The majority of patients report less pain by using the endoscopy method in comparison to the open release procedure. However there have never been any significant long-term advantages of any of the methods in terms of your grip strength, muscles and dexterity. You will typically find that your hands are incapacitated for up to 2 weeks and it is recommended that you have someone who can help you around the house during this time. If you work in a strenuous or physical job, you should not return to work for at least a month as this can cause symptoms to return. However, you may wish to take into consideration, that your recovery time will be far faster with an endoscopy in comparison to open release.
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