We use our hands almost every minute of the day without thinking about it. But when carpal tunnel syndrome sets in, the pain, numbness, and tingling might make you think twice. Conservative treatments like braces and pain relievers can help, but they aren’t always the most effective, especially in severe cases.
Here, our team of specialists at Somers Orthopaedic Surgery takes a closer look at carpal tunnel syndrome and some of the warning signs that indicate you need surgery to fix it.
What is carpal tunnel syndrome?
Before diving into the surgery, it’s best to understand exactly what the carpal tunnel is. The carpal tunnel is a narrow passageway in your wrist surrounded by bones and ligaments. A critical nerve called the median nerve runs through the carpal tunnel. Your median nerve is responsible for much of your arm and hand’s sensation and function.
Anything that compromises the carpal tunnel and puts pressure on the median nerve results in carpal tunnel syndrome. Typically, carpal tunnel syndrome triggers tingling, numbness, weakness, and pain in your hand, wrist, and arm.
What causes trouble in your carpal tunnel? More than you may realize. Some of the most common causes of carpal tunnel syndrome include:
- Wrist fractures or dislocation
- Anatomically small wrist
- Nerve-damaging conditions, such as diabetes
- Certain medication
- Fluid retention
- Medical conditions, such as menopause
You’re also at an increased risk if your job requires repetitive movements, holding your wrist in an unnatural position, or working with vibrating tools, all of which put an inordinate amount of strain on your wrist and can irritate your median nerve.
When do I need surgery?
Though it can be frustrating and painful, most cases of carpal tunnel syndrome go away on their own with conservative interventions. Typically, we begin treating it with bracing, physical therapy, anti-inflammatory medication, regenerative medicine, etc.
There are a few reasons why we might recommend surgery. Over time, carpal tunnel syndrome can weaken the muscles in your hands and wrists, and if it goes on for too long, your condition can keep getting worse.
You may need surgery if you haven’t responded to conservative treatments, your symptoms haven’t improved in six months, or you’ve started to lose your ability to use your hands.
What happens during carpal tunnel syndrome surgery?
It’s disheartening to hear you need surgery, but the good news is that carpal tunnel syndrome surgery is a relatively simple procedure and highly effective — and you have options.
There are two main types of carpal tunnel surgery: open and endoscopic. The goal of both is to cut or release the ligament around the carpal tunnel to relieve pressure on your median nerve. After surgery, the ligament eventually comes back together, but this time there’s more room for your median nerve to pass through.
The difference between the two types of surgery has to do with the size and location of the incision.
In open surgery, we create a larger incision (around two inches) from your wrist to your palm. This gives us adequate access to your carpal tunnel.
Endoscopic surgery involves making a smaller (about a half-inch) opening in your wrist. Then, we place a tiny camera in the opening to guide us as we cut the ligament. We may also make a similar incision in your upper arm if we need more access.
Because the endoscopic approach requires smaller incisions and therefore less time in recovery, we typically recommend it over open surgery.
Most of our patients who undergo surgery find that their symptoms go away and don’t come back. If you have a severe case of carpal tunnel syndrome, you may still notice mild symptoms from time to time.
Frustrated with carpal tunnel symptoms that won’t go away? We’d love to talk with you as you consider your options. Call or click to schedule an appointment with one of our experts today.