With the increasing importance of computers, hand doctors are seeing a rising number of cases of carpal tunnel syndrome (CTS). Surgery is an effective choice for many patients. Knowing what to expect before undergoing this type of hand surgery can make the process go more smoothly and reduce stress.
Who Should Have a Carpal Tunnel Procedure
The most common conservative types of therapy a hand specialist recommends for this disorder are corticosteroid injections and splinting, according to the University of Maryland Medical Center. The objective is to begin therapy in the early stages, before damage significantly progresses.
However, when conservative measures fail to control the symptoms of CTS within two to seven weeks, a hand doctor usually recommends another type of treatment, such as limiting movement or specific exercises. For many patients, CTS surgery is the alternative that brings relief.
This surgery is one of the most common procedures a U.S. hand surgeon performs. However, minimally invasive endoscopic carpal tunnel release isn’t a cure for all patients. For best results, it should be performed by a hand specialist who is an expert at this type of surgery. The ideal candidate is one who:
- Undergoes surgery within three years of diagnosis
- Has good general health
- Has slow nerve conduction results, but good muscle strength
- Experiences symptoms worse at night than in the daytime
Preparation Before the Procedure
Many patients have questions about risk. The Hand Center at the University of Washington reports that one study found that in 10,000 consecutive surgeries, patients experienced no long-term complications that necessitated another surgery. Risks include nerve infection, symptom recurrence and scar tenderness.
Preparation for surgery is minimal.
In addition to completing any health insurance or other requirements, patients should plan to spend at least a week away from the job, depending on their type of work, and should arrange for an adult to accompany them home after the operation.
The Day of Surgery
Most CTS surgery is performed under local anesthesia on an outpatient basis, according to the American Academy of Orthopaedic Surgeons. A hand surgery doctor performs it by making a half-inch incision in the patient’s wrist.
A tiny camera and a knife inserted through a lit tube guide the surgeon, who cuts the ligament linked to the compressed median nerve. Glue rather than stitches closes the incision.
Few patients require pain medication. Most are able to resume many daily activities right away.
The hand specialist who performed the surgery will advise when returning to work is appropriate. A premature return could cause symptoms to come back. Many patients initially experience a decline in the strength of their grip and in dexterity. Improvement can continue for months.