Raleigh Hand to Shoulder Center in Raleigh, NC

Carpal Tunnel Surgery

Carpal tunnel surgery is one of the most common surgeries performed by hand surgeons in the United States. This article will explain the surgery in detail for patients with carpal tunnel syndrome. Find out if carpal tunnel surgery is right for you with the help of the professionals at Raleigh Hand to Shoulder Center. 

If you’ve been experiencing persistent wrist pain, hand pain, numbness, tingling, or weakness in your hand, you’re not alone. Carpal tunnel syndrome is a common condition that can significantly impact your quality of life. Fortunately, our team of skilled and compassionate Raleigh orthopedic hand surgeons is here to offer you a solution.

At our practice, we understand the importance of regaining the full functionality of your hand and wrist. Our surgeons are highly experienced in performing carpal tunnel surgery, a procedure designed to alleviate the compression of the median nerve in the wrist, relieving pain and improving hand function. 

What is Carpal Tunnel Syndrome? 

Carpal Tunnel Syndrome (CTS) is a common medical condition that causes hand pain and wrist pain. It occurs when the median nerve, which runs from the forearm into the hand, becomes compressed or squeezed as it passes through a narrow passageway called the carpal tunnel. 

The carpal tunnel is a rigid structure located on the palm side of the wrist, and it is made up of bones and a strong band of connective tissue known as the transverse carpal ligament.

When pressure builds up within the carpal tunnel, it can lead to a range of uncomfortable and sometimes debilitating symptoms that lead to wrist pain and hand pain. 

What Are the Symptoms of Carpal Tunnel? 

The symptoms of carpal tunnel syndrome can vary in severity and may include the following:

  • Hand Pain 
  • Wrist Pain
  • Forearm Pain
  • Numbness and Tingling
  • Weakness
  • Difficulty with Fine Motor Skills
  • Hand and Wrist Swelling
  • Worsening Symptoms at Night
  • Radiating Pain

CTS symptoms can progress gradually over time, and they may come and go initially. Some individuals may only experience mild discomfort, while others may have more severe symptoms that significantly impact their daily lives. If you suspect you may have carpal tunnel syndrome or are experiencing symptoms consistent with CTS, it is recommended to seek medical evaluation and diagnosis from a skilled practitioner. 

Do I Need Carpal Tunnel Surgery?

When non-surgical treatment has not alleviated the carpal tunnel symptoms of hand numbness, tingling, and pins and needles pain, carpal tunnel surgery should be considered. If you cannot sleep at night due to hand numbness/tingling or if you cannot complete daily tasks such as driving, cooking, or typing without the hand going numb, surgery should be considered. 

If the stretches, wrist splints, and injections are no longer helping, carpal tunnel surgery should be considered. Also, carpal tunnel surgery is recommended to prevent further nerve damage if there are signs of existing nerve damage, such as thumb muscle loss or constant numbness in the thumb, index, and middle fingers.

Let’s look at the factors that may indicate you are a good candidate for carpal tunnel surgery. 

Persistent Symptoms

Suppose you have been experiencing persistent and severe symptoms of CTS, such as severe hand pain, wrist pain, numbness, tingling, weakness, and functional limitations, despite trying conservative treatments like wrist splinting, physical therapy, and medication. In that case, surgery may be considered as an option.

Objective Nerve Impairment

Diagnostic tests, such as nerve conduction studies or electromyography (EMG), may reveal objective evidence of nerve impairment in the median nerve. If these tests confirm the presence of nerve damage, surgery may be recommended to prevent further deterioration.

Functional Limitations

If CTS is significantly impacting your ability to perform essential daily tasks or work-related activities, surgery may be considered to improve your hand function and quality of life.

Failed Conservative Treatments

If you have diligently tried non-surgical treatments for an adequate period, and they have not provided satisfactory relief, your healthcare professional may suggest surgery as the next step.

Severity of Symptoms

The severity of your CTS symptoms, as assessed by your healthcare provider, plays a significant role in determining the need for surgery. Symptoms that are mild or infrequent may not warrant surgery right away, while severe and disabling symptoms are more likely to lead to a surgical recommendation.

Patient Preference

Ultimately, the decision to undergo carpal tunnel surgery should be a collaborative one between you and your medical providers. Your preferences, goals, and willingness to undergo the procedure should be taken into account.

How is Carpal Tunnel Surgery Performed?

Carpal tunnel surgery is performed as an outpatient usually in a surgery center. The doctors at Raleigh Hand to Shoulder Center operate mostly at Capital City Surgery Center. 

Preparing for Carpal Tunnel Surgery

Before surgery is started, the hand and wrist are numbed with an injection of numbing medication. Oral valium or IV sedation anesthesia can be used as well. General anesthesia is not required. 

Carpal Tunnel Surgery Process

During carpal tunnel surgery, the roof of the carpal tunnel is opened by cutting a thick ligament in the palm. Once this ligament is cut, the size of the carpal tunnel space is increased to take pressure off the nerve. This ligament regrows over time, but it allows more room for the nerve within the carpal tunnel afterward. This ligament is called the transverse carpal ligament.

The length and type of skin incision varies among surgeons. The common goal is to make more room for the nerve within the carpal tunnel and to take pressure off the nerve. Nowadays most hand surgeons are able to use a smaller, less-invasive incision than when the procedure was invented many years ago. The recovery from surgery is much faster today than in the past. 

Techniques Used for Carpal Tunnel Surgery

Open and endoscopic carpal tunnel releases are two common surgery options. The recommended procedure for you will be discussed by your doctor.

Open Carpal Tunnel Surgery

In this traditional approach, a small incision is made in the palm of the hand near the base of the wrist. The surgeon then cuts the transverse carpal ligament—the band of tissue that forms the roof of the carpal tunnel—to release pressure on the median nerve.

Endoscopic Carpal Tunnel Surgery

This minimally invasive technique involves the use of a thin, flexible tube with a camera (endoscope) to guide the surgeon. A small incision is made in the wrist, and the transverse carpal ligament is cut using specialized instruments. Endoscopic surgery typically results in smaller scars and a quicker recovery compared to open surgery.

What is the Success Rate of Carpal Tunnel Surgery?

Over 90% of patients are pleased with the results of carpal tunnel surgery and would recommend this surgery to their family and friends. Most patients have significantly less hand pain and numbness after carpal tunnel surgery and can sleep through the night without tingling in their hands. Many patients are so pleased with the relief of their symptoms that they wish that they had carpal tunnel surgery years ago.

What is the Recovery After Carpal Tunnel Surgery?

Patients may use their hands for light activities right away after carpal tunnel surgery. No cast or splint is required after carpal tunnel surgery. Many patients do not require opioid pain medications if they can take oral ibuprofen combined with Tylenol. 

Most patients can return to office work within a week of this surgery. Using a computer is slower at first, but then gradually gets much easier. Heavy manual labor is usually not recommended until about 3 weeks or so after surgery. Most patients do not require physical or occupational therapy after carpal tunnel surgery. The grip strength gradually improves back to normal in a few weeks.

What Are the Risks of Carpal Tunnel Surgery?

Temporary soreness in the palm or wrist can occur with carpal tunnel surgery and gradually gets better with time. Infection, scar tissue, and wound healing problems are possible but not very common. Some patients do not have complete relief of carpal tunnel symptoms, especially in severe or long-standing cases. 

Injury to the nerve during surgery is very rare. There is a less than 5% chance that carpal tunnel syndrome returns after successful carpal tunnel surgery. Most patients are very pleased with their outcome following carpal tunnel surgery.

Get Freedom from Hand and Wrist Pain at Our Surgery Center in Raleigh 

It’s essential to have a thorough evaluation by a qualified hand and wrist surgeon to determine if surgery is the appropriate course of action for your specific case. 

Please make an appointment with Raleigh Hand to Shoulder Center doctors to learn more about your treatment options for your carpal tunnel syndrome. Get relief from your carpal tunnel syndrome and get back to the life you enjoy.

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