After a long workday, you may struggle with a numb feeling in your wrists and hands. This numb, tingling sensation can be frustrating—especially when it makes simple, everyday tasks painful.
Carpal tunnel syndrome (CTS) is a condition that affects the median nerve to the hand. CTS can be treated without surgery, but some severe cases may require surgical intervention. Read on to learn more about the current methods of managing carpal tunnel pain and whether you may be a good candidate for carpal tunnel surgery.
What is carpal tunnel syndrome?
The carpal tunnel is a narrow passageway on the palm side of the hand that is surrounded by bones and ligaments. It houses the median nerve, which runs from the neck all the way down through the arm and wrist. When pressure is applied to the median nerve, it can cause numbness, tingling, and pain in your hand and fingers. This is known as carpal tunnel syndrome.
Carpal tunnel syndrome may affect your grip strength, leading to difficulty with writing, typing, cooking, driving, and other everyday activities. These symptoms can affect you during the night and limit your sleep, as well as cause pain.
What causes carpal tunnel?
Often, we think of frequent computer use as causing carpal tunnel syndrome, but there are many causes. Repetitive wrist motion and vibration can also bring on carpal tunnel syndrome. CTS can affect patients in nearly all professions.
Some conditions may also increase your risk of developing carpal tunnel. These include:
- Rheumatoid arthritis
Women are at a higher risk of developing carpal tunnel syndrome. It can also run in families, so if you have someone in your family who has struggled with carpal tunnel, you may also be at an increased risk.
If you struggle with numbness, tingling, or pain in your wrists, arms, and/or hands, making an appointment with a doctor can be the first step towards finding relief.
An orthopaedic surgeon (a doctor who specializes in the musculoskeletal system) can help diagnose carpal tunnel syndrome and help you develop a treatment plan to reduce pain.
An orthopedic expert can run a variety of tests to help determine whether your symptoms are consistent with CTS. Some of these tests include:
- Tinel’s test. During the tinel test, your doctor will engage your median nerve to determine whether pressure on it is resulting in your symptoms. This is done by lightly tapping on certain areas of your hand.
- Phalen’s test. During this test, you’ll be asked to hold your forearms upright and press the backs of your hands together with your fingers pointing down. If you begin feeling numbness, tingling, or pain within about 1 minute of holding this position, it may indicate CTS.
- Electrodiagnostic testing. To determine the severity of damage to your median nerve, your doctor may refer you to a neurologist to insert a needle into the muscle and stimulate with a small amount of electricity. This test is commonly performed before surgery.
- Ultrasound. An ultrasound may be used to spot any abnormalities with your median nerve.
Mild cases of CTS may be treated with at-home exercises, therapy, and splints that help reduce the pressure on your median nerve. You may also receive medication, like anti-inflammatories or steroid injections, to help reduce pain and other symptoms.
However, if these methods don’t bring you relief, your orthopaedic surgeon may discuss carpal tunnel surgery with you.
How Carpal Tunnel Surgery Can Help
The numbness and tingling associated with carpal tunnel syndrome is caused by pressure on the median nerve. That means that reducing pressure through surgery may help to reduce those sensations of pain and tingling in your hand. Physical therapy may also be helpful after surgery in order to regain hand motion and strength.
To learn more about whether this is a viable option for you, schedule an appointment with an orthopaedic hand surgeon.
The Carpal Tunnel Surgery Process: What to Expect
Carpal tunnel release surgery is an outpatient surgery, so you typically will not need to stay overnight at a hospital. This type of surgery is generally performed at an ambulatory surgery center or a hospital.
General anesthesia (meaning you will be asleep during surgery) is not commonly used for carpal tunnel surgery. Typically, a local anesthetic will be applied to your wrist to numb the area, and you will be given medicine to make you calm and drowsy during the procedure.
Depending on the severity of your carpal tunnel syndrome and your unique physiology, your orthopaedic hand surgeon will choose to perform either a mini-open or an endoscopic surgery.
- During a mini-open surgery, an incision will be made on your palm. Your doctor will use this incision to release the transverse carpal ligament in order to increase the size of your carpal tunnel.
- During an endoscopic surgery, your surgeon will make one small incision on your wrist. Then, they will insert a camera and specially designed tools to cut through the transverse carpal ligament in order to increase the size of your carpal tunnel.
Carpal Tunnel Surgery Recovery
After your surgery, you can move your fingers immediately, but you’ll need to rest your hand in order to fully recover.
During the first two days post-op, you’ll need to keep your hand elevated and iced. Your dressing will generally remain on for 5 days. Once the dressing is removed, you may then wash your hand and cover the incision with a band aid. Depending on your job, you may need to take time off from work in order to fully recover from surgery.
Some patients feel immediate relief after surgery, while others may take months to notice an improvement. Some patients may also benefit from physical therapy after surgery. Depending on how your wrists and hands feel, your surgeon will discuss different options with you after surgery.
Potential Risks and Side Effects
As with any surgery, there are risks associated with carpal tunnel surgery.
You may experience:
- Redness around the incision
- No improvement or worsening of symptoms
Your surgeon will tell you what to do if you experience any of these side effects.
Is Carpal Tunnel Surgery Right for You?
If carpal tunnel syndrome is interfering with your everyday activities or impacting your sleep, it’s time to seek medical care. Without treatment, your carpal tunnel syndrome may worsen and lead to permanent nerve and muscle damage.
Your hands and wrists are important, so make sure to take care of them! Carpal tunnel surgery may alleviate your symptoms and help you get back to living everyday life. An orthopaedic surgeon can talk to you about your symptoms and evaluate the severity of your CTS to help make treatment recommendations that are best for you.
About Dr. Gaskins
A Florida native, Dr. Roger “Casey” Gaskins is a board-certified orthopaedic surgeon with training from UF, USF, and Wake Forest University. Dr. Gaskins creates customized, individualized treatment plans for patients of all ages with the aim of minimizing pain and maximizing physical function.
Dr. Gaskins and his team specializes in hand surgery, treating patients struggling with carpal tunnel syndrome, arthritis, fractures, nerve injuries, and other conditions that affect the wrists, hands, and fingers.
Disclaimer: This blog is not intended to substitute professional medical advice. Always talk with your doctor before starting or stopping medications or treatments.