Surgical Treatment for Carpel Tunnel Syndrome
One of the most common peripheral neuropathies, carpal tunnel syndrome (CTS) is a condition caused by the compression of the median nerve. If you have sought early diagnosis for your carpal tunnel syndrome when your condition is still mild, you are most likely to recover with non-surgical treatments alone. Mild cases of this condition or those diagnosed during the early stages are generally treated with non-surgical treatments such as pain medications and anti-inflammatory drugs, physical therapy, exercise, alternative treatments (acupuncture and chiropractic care).
When surgery is indicated
Your doctor will most likely recommend you to have surgery if:
* Your symptoms persist or worsen after a long period of non-surgical therapies. Surgery is generally considered only after around 3 to 12 months of undergoing non-surgical treatments. However, if nerve damage is obvious even before three months, surgery would be an immediate choice.
* Your symptoms are severe that engaging in normal activities is hampered.
* The median nerve is obviously damaged as evidenced by positive nerve test results and loss of hand or finger function, or a risk of nerve damage is present.
Surgical treatment
There are two types of surgical procedures that a surgeon usually performs to correct the damage sustained by the median nerve in carpal tunnel syndrome. Done under local anesthesia and do not usually require you to stay overnight in the hospital unless there are other medical considerations, these surgical procedures include:
Open release surgery
Considered the conventional surgical technique of correcting median nerve damage associated with CTS, this procedure consists of making an incision (up to 2 inches long) in the wrist and then cutting the carpal ligament to enlarge the carpal tunnel thereby reducing pressure on the median nerve.
Endoscopic surgery
This type of surgical procedure may be done using either one of its two variations. In the single portal endoscopic surgery, the surgeon makes a small incision (about 1/2 inch long) on the wrist. While in the two-portal endoscopic surgery, two small incisions are made – one on the wrist, and one on the palm. Either of these techniques involves insertion of an endoscope, a flexible tube with a camera attached. This apparatus allows the surgeon to see the structures (like the transverse carpal ligament) on a screen without making a large incision on the affected area, enabling him/her further to cut the carpal ligament to relieve pressure on the median nerve. Once the median nerve is free from compression, relief of CTS symptoms is expected.
Expectations after surgery
Because incisions are smaller in endoscopic surgery, a shorter recovery period is expected with this surgical procedure. The pain and numbness associated with carpal tunnel syndrome generally disappear immediately after surgery, or it may still a few months. You need to refrain from extensive use of your hand for two weeks.
How effective is surgery
Majority of people completely recover from carpal tunnel syndrome after undergoing surgery. Overall, both surgical procedures have a success rate of at least 95%. In some rare cases, complications such as recurrence of pain and numbness may occur, or grip strength may be temporarily lost due to the cutting of the carpal ligament.
However, if the muscles in your thumb have been severely weakened or atrophied (wasted), the strength and function of your hand may still be limited even after undergoing surgery.
You may need to undergo physical therapy or occupational therapy to help regain strength and function of your hand.
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