Carpal Tunnel Syndrome

What is Carpal Tunnel Syndrome?

Carpal Tunnel Syndrome is a disease of the hand characterised by pain, tingling, numbness and weakness. This disease most commonly affects the middle and index fingers and the thumb and symptoms are usually most problematic at night.

This condition typically develops in patients with abnormally high pressure in the Carpal Tunnel, which in turn causes compression of the Median Nerve. The Median Nerve travels down the arm and enters the hand through the Carpal Tunnel, which is situated in the central part of the wrist.

The exact reasons for this condition developing in around 5% of the population is unclear, although the following risk factors are associated:

• Occupations involving repetitive wrist flexion and extension
• Pregnancy
• Rheumatoid Arthritis
• Diabetes
• Hypothyroidism
• Wrist Fracture
• Alcoholism 

How is Carpal Tunnel Syndrome treated?

Although Carpal Tunnel Syndrome is rarely an emergency, it has been proven that the earlier patients seek treatment the more likely this condition is to respond to non-surgical intervention. If Carpal Tunnel Syndrome is left untreated for a long time it is possible that irreversible damage to the Median Nerve and related weakness and numbness will occur.
   
This first line of treatment for a patient experiencing mild symptoms will be to enforce rest on the affected limb and to apply a support brace to the wrist to restrict movement and reduce nerve irritation. More serious cases or those that fail to respond to enforced rest will require Carpal Tunnel Release Surgery, which is aimed at taking the pressure off the Median Nerve.

How is a Carpal Tunnel release procedure carried out?

A Carpal Tunnel Release can be performed under General Anaesthetic (you will be asleep) or Regional Anaesthetic (you will be awake). The procedure usually takes only a short amount of time to perform (approximately 30 minutes). Most procedures are provided on a Day-Case basis.

During a traditional release procedure the surgeon will make a small incision (cut) over the palm side of the wrist and then release the ligament that covers the Carpal Tunnel. By releasing this ligament the Carpal Tunnel increases and pressure is relieved on the Median Nerve.

Minimally Invasive Surgical (MIS) procedures are also becoming increasingly popular technique performed by Specialist Hand Surgeons to correct this condition. MIS is also known as 'keyhole surgery" and provides a surgeon with a quick, easy and clear view of the inside of the Carpal Tunnel through a pencil slim, high-resolution camera known as an Arthroscope. The camera also includes a light source, which allows the image picked up through the camera lens to be projected onto a television monitor. The surgeon can then view the Carpal Tunnel in an enlarged format and with the aid of clear vision via the camera lens guide his fine instruments through another key hole incision and release the ligament without a need to fully open up the wrist.
 
At the end of either procedure the wound or keyhole incisions are closed with absorbable stitches or a simple dressing.

What is the recovery like?

Once a patient is fully recovered from the effects of anaesthetic they are normally quickly encouraged to be as active and mobile as possible to avoid complications such as joint stiffness and Deep Vein Thrombosis from developing. It is therefore normal for patients to be encouraged to undertake upper limb physiotherapy exercise just a few hours after surgery. Following a progressive improvement of mobility and pain control, patients are normally discharged home 4-6 hours after their surgery.

The relief of symptoms can be immediate or progressively noticed over a period of weeks. During the next 6 weeks patients will be expected to work on improving their joint and hands mobility and range of movement through dedicated and progressive physiotherapy. Your Consultant Surgeon will then assess your condition and range of movement after 1 week and then again after six weeks to evaluate how successful the release procedure has been.

Patients who are in employment should not resume work until after their first consultation and dependant on the physical nature of their job may be advised to take longer off work. Patients should expect a continuous and full physical recovery to take from 6 - 12 weeks to achieve.

Are there any risks associated Carpal Tunnel Release surgery?

Although Carpal Tunnel Release is regularly performed without any complications, it is very important that all candidates are fully aware of both the benefits and risks of undertaking this type of specialist Hand surgery.

All surgery, no mater how expertly or carefully it is performed, carries risks and the importance of a full evaluation and consultation with an expert in Carpal Tunnel Release surgery to discuss your condition in relation to these risks cannot be over emphasised.

How do I find out if I am a suitable candidate for Carpal Tunnel Release surgery?

Surgical Advisor will be delighted to help you find a leading expert in Hand and Wrist surgery to consult with. Your surgeon will carry out a thorough evaluation of your condition and provide you with a comprehensive explanation of the most appropriate surgical solution.
 
Our Expert Consultant Orthopaedic Surgeons are most carefully selected and recommended because they understand the importance of the decision you are making when contemplating complex Hand and Wrist surgery and because of their specialist upper limb surgery expertise. Throughout your consultation you will therefore be encouraged to ask as many questions as you wish and to take your time in making a decision to proceed with any recommended treatment.

To ensure that patients are comfortable with any recommendations or advice given in their consultation, all patients are asked to go away after a consultation and think through all the information they have received. If for whatever reason you are still not sure about the best course of action and wish to have further dialogue with your surgeon, you will not be expected to pay for a second consultation appointment.

How do I make a consultation appointment?

For further advice on how to make an appointment to consult with an expert Hand and Wrist surgeon: 

Please call Surgical Advisor on: 0870 41 41 41 2
Or email us by clicking on: advice@surgicaladvisor.com