Age, heredity, overuse of your hand during a long period of time, and other diseases such as arthritis and diabetes can constrict your carpal tunnel passage, the area in your wrist that is surrounded by carpal ligament tissue at the top and your carpal bones at the base. Within the tunnel itself are the median nerve and other tendons that facilitate your full range of finger movement. If any of the previously mentioned conditions should occur, your carpal tunnel passage may begin to swell, causing the fingers to tingle and feel numb, usually over time and generally on the side of your hand closest to your thumb, and you may also experience sporadic pain in various parts of your hand that worsens with decreased activity. For many people, these conditions worsen if untreated, although your provider will usually encourage anti-inflammatory medications, bracing, splinting, modifications in activity, and other steps first. If your condition isn’t alleviated by nonsurgical methods within a short period of time, and depending upon the severity of the pain and numbness in your hand, your provider may recommend carpal tunnel release surgery to restore your carpal tunnel passage.
Carpal tunnel release surgery is performed in order to increase the carpal tunnel passage space to benefit the tendons and the median nerve located within. As a routine, outpatient procedure, this process involves controlling swelling and pressure and alleviating compression and pain in the carpal tunnel passage in order to successfully correct the carpal tunnel condition. During the operation, your provider will cut your transverse carpal ligament, which will eventually scar and heal on its own after the procedure and which releases swelling, pressure and other carpal tunnel symptoms. There are two methods for completing the surgery, open carpal tunnel release and endoscopic carpal tunnel release, and both methods involve cutting the transverse carpal tunnel ligament. A small incision is made in the palm during open surgery to allow for a view of the wrist and hand, while endoscopic surgery involves one to two portals, or skin incisions, and the use of a small camera to view the affected area and a special incision tool to complete the procedure. Generally, each type of procedure has similar outcomes.
Did You Know? Recent statistics show that roughly 2% of men and 3% of women will be diagnosed with carpal tunnel syndrome during their lifetimes, with older adults, including women over age 55, being at a higher risk than younger people. As one of the most common procedures performed in the U.S., carpal tunnel release surgery has helped 70-90% of clinical trial patients avoid post-surgery nighttime pain and has proven to provide greater long-term relief than splinting, anti-inflammatory medications, or hand therapy.
The recovery time for most patients is within a few months after surgery, however, this time frame requires active participation in physical therapy and is dependent upon individual factors for each patient. Elevation of your hand above your heart and frequent finger movement will help avoid stiffness and inflammation, and the wearing of a splint or brace and limiting yourself to light activities will facilitate the healing process. Depending upon the severity of the condition of your median nerve prior to surgery, your gripping and pinching strength will return within two-to-three months or six months to a year after the procedure. Pain and numbness are alleviated by carpal tunnel release surgery for many patients, with some experiencing continued symptoms or deceased strength after surgery, and hand mobility and force being diminished for others due to different but related conditions. Should pain persist, your physician may refer you to a hand therapist.