What is carpal tunnel syndrome?
Carpal tunnel syndrome is caused by pressure on a nerve in your wrist and it can be very painful.
The carpal tunnel is an opening in your wrist that is formed by the carpal bones on the bottom of the wrist and a ligament called the ‘transverse carpal ligament’ across the top of the wrist. The median nerve provides sensory and motor functions to the thumb and 3 middle fingers.
There are many reasons why this may happen and it can be challenging to identify one specific reason. In many cases, there will be multiple factors at play.
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Ready to book now? Get in touch to discuss your needs and decide on the best course of treatment for you.
What is carpal tunnel release surgery?
If your symptoms are severe or other treatments, such as steroid injections or wrist splints, did not work for you, surgery may be recommended. Carpal tunnel surgery, also known as a ‘carpal tunnel release’ is usually carried out as a day case, under local anaesthesia. This will relieve pressure on your median nerve. It’s generally very effective and has a high success rate.
What happens during carpal tunnel release surgery?
There are two types of carpal tunnel release surgery.
- Open release – the surgeon operates through a cut in the wrist
- Endoscopic tunnel release – a thin, flexible tube with a camera is put into the wrist through a small incision. The surgeon uses the camera to see inside the wrist and operates using small tools.
Here’s what you can expect from both procedures:
- Typically, local anaesthetic will be used to numb the hand and wrist
- In an open release surgery, the surgeon will make an incision in your wrist. They will then cut the carpal ligament and enlarge the carpal tunnel
- In an endoscopic (keyhole) carpal tunnel release, the doctor makes one or two very small incisions. The number of incisions depends on the technique used. The camera will be inserted via one incision. The camera guides your doctor as they insert the instruments and cut the carpal ligament through the other incision
- Once the surgery is complete, your incisions will then be stitched up
- Your hand and wrist will be placed in a splint or bandaged to limit motion in the wrist and promote healing.
Only in rare cases is an overnight stay needed for a carpal tunnel release surgery.
Symptoms of carpal tunnel syndrome
Carpal tunnel symptoms normally affect your thumb and fingers. Typical symptoms include:
- Numbness
- A tingling feeling
- Weakness and finding it difficult to grip with your hand or fingers
- Pain or a burning feeling.
You may feel carpal tunnel symptoms in one hand or both. It can affect your hand and also spread up your arm. Your symptoms may get worse over time. Generally speaking, you may find that your symptoms are worse at night and certain activities, such as typing on a computer keyboard, may trigger the discomfort.
Causes of carpal tunnel syndrome
There many reasons why you may experience this and it’s likely to be a combination of factors. The following can increase your chances of developing carpal tunnel syndrome:
- Doing repeated activities that put your wrist in an unnatural position, for example over-flexed or extended
- Being overweight
- Having diabetes or an underactive thyroid
- Pregnancy, which may cause fluid retention
- Injury to your wrist such as a wrist fracture
- Rheumatoid arthritis
- A tumour or growth pressing on the nerve making the carpal tunnel narrower (very rare).
Carpal tunnel syndrome treatment
You don’t always need treatment for carpal tunnel syndrome. For some people, the symptoms improve on their own within a few months. But, this is more likely if you’re under 30, and especially if your symptoms are due to pregnancy. If you are living with arthritis, treating it may help your carpal tunnel symptoms.
Wrist splints
As a first course of action, your doctor will likely recommend wrist splints. Wrist splints keep your wrist straight while reducing pressure on your compressed nerve. It’s usually recommended that you wear a wrist splint for at least six weeks.
Steroid injections
Your consultant may recommend steroid injection therapy into your carpal tunnel to help relieve your pain. Steroid injections are anti-inflammatory, so they may reduce your swelling and the pain.
Carpal tunnel release surgery
If your symptoms are severe or other treatments did not work for you, surgery may be recommended. Carpal tunnel surgery, also known as a ‘carpal tunnel release’ is usually carried out as a day case, under local anaesthesia. This will relieve pressure on your median nerve. It’s generally very effective and has a high success rate.
Preparing for carpal tunnel release surgery
Your surgeon will give you simple preparation advice to help you get ready for your operation. This surgery will be carried out under local anaesthetic as a day surgery, so there is no need to pack an overnight bag.
You may be advised to stop taking medications a few days before surgery, particularly if you take aspirin or other blood-thinning drugs.
If you smoke, you may be advised to stop. This is because smoking increases your chances of getting a wound infection, which can slow down your recovery after surgery.
You won’t be able to drive immediately after your surgery, so make sure you arrange to get a lift home.
It is advised that you prepare your home and living arrangements for your return from hospital. It may be challenging to carry out day to day tasks after your surgery. You may need to fill your fridge with food that is easy to prepare for the few days after your surgery. You may also need some extra help around the house too, so see if a friend or family member can stay with you to support.
What are the alternatives to carpal tunnel release surgery
If you have carpal tunnel syndrome, your doctor may recommend other treatments before you resort to surgery. These include:
- Steroid injections
- Wearing a wrist brace.
If the above treatments are not alleviating your symptoms, you may be referred for surgery.
What happens after carpal tunnel surgery
After your surgery, it may take a few hours for the local anaesthetic to wear off. You may feel some tingling while this happens and you may need to take some pain relief. You’ll need to be careful not to bump or knock your hand.
You’ll usually be able to go home when you feel ready. This may be about an hour or two after your operation. You may be given a date for a follow-up appointment before you leave. If you’ve had a general anaesthetic, ask a friend or relative to take you home. Also ask them to stay with you for a day or two while the anaesthetic wears off.
Your bandage will protect and support your hand, but you should still be able to move your fingers. Keeping your hand warm and regularly moving your fingers will help to promote a swift recovery.
Recovering from your surgery
Recovery time varies from person to person as everyone responds slightly differently to their surgery. Your surgeon will discuss the best post-operative regime with you. You may need a few weeks off work.
Complications and side effects
The most common complications associated with carpal tunnel release surgery include:
- Infected wounds. These can be treated with antibiotics
- Bleeding, which may collect under your skin (a haematoma)
- A tender and sensitive scar. Typically, this improves over time. However, in rare cases this can continue long-term and interferes with day-to-day activities
- Damage to nerves in your wrist. This may cause temporary pain and numbness in your hand. In very rare cases, this could be permanent
- Ongoing pain. This is very rare but be sure to tell your surgeon if you’re experiencing any problems. You could be referred for further treatment, such as physiotherapy.
Cost
Please call us to discuss pricing at your local clinic.
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Carpal tunnel release surgery £1,375.00