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By Dr. Divya Nagpal Blog Published on - 16 April - 2023

What to Expect During a Carpal Tunnel Release Procedure

Carpal Tunnel Syndrome (CTS) is a common condition that affects the hand and wrist, causing pain, tingling, and numbness. If conservative treatment options fail to provide relief, a carpal tunnel release procedure may be recommended by a healthcare professional. If you are scheduled for this procedure, it's natural to have questions and concerns about what to expect. In this blog, we will provide you with a comprehensive overview of what to expect during a carpal tunnel release procedure.

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What is Carpal Tunnel Syndrome?

Before diving into the details of the procedure, let's understand what carpal tunnel syndrome is. The carpal tunnel is a narrow passageway in the wrist that houses the median nerve, along with tendons that control the movement of the fingers. When the median nerve becomes compressed or squeezed within the carpal tunnel, it leads to a condition known as carpal tunnel syndrome. The most common symptoms of CTS include pain, numbness, tingling, and weakness in the hand, particularly in the thumb, index, middle, and ring fingers.

Conservative Treatments for Carpal Tunnel Syndrome

When diagnosed with carpal tunnel syndrome, conservative treatments such as splinting, nonsteroidal anti-inflammatory drugs (NSAIDs), and corticosteroid injections may be recommended initially. Physical therapy, changes in ergonomics, and activity modifications can also be beneficial in managing mild to moderate cases of carpal tunnel syndrome. However, if these conservative treatments fail to provide relief, your healthcare provider may suggest a carpal tunnel release procedure as the next step.

Understanding Carpal Tunnel Release Procedure

A carpal tunnel release procedure is a surgical intervention that aims to relieve the pressure on the median nerve within the carpal tunnel. There are two types of carpal tunnel release procedures: open release and endoscopic release. Let's take a closer look at each procedure.

  1. Open Carpal Tunnel Release Procedure: In an open carpal tunnel release procedure, the surgeon makes a small incision, usually about 2 inches, in the palm of the hand. The transverse carpal ligament, which forms the roof of the carpal tunnel, is then cut to relieve the pressure on the median nerve. The incision is closed with sutures, and a bandage is applied.
  2. Endoscopic Carpal Tunnel Release Procedure: In an endoscopic carpal tunnel release procedure, the surgeon makes one or two small incisions, usually less than half an inch each, in the wrist or palm. A thin tube with a camera, called an endoscope, is inserted through one of the incisions to visualize the inside of the carpal tunnel. The surgeon uses specialized instruments inserted through the other incision(s) to cut the transverse carpal ligament, relieving the pressure on the median nerve. The incision(s) is closed with sutures, and a bandage is applied.

What to Expect Before the Procedure?

Before the carpal tunnel release procedure, you will have a pre-operative evaluation with your healthcare provider. This may include a physical examination, review of your medical history, and possibly some imaging tests such as X-rays or nerve conduction studies to confirm the diagnosis and assess the severity of your condition. Your healthcare provider will also provide you with detailed instructions on how to prepare for the procedure, which may include avoiding food and drink for a certain period of time before the surgery, discontinuing certain medications that may increase the risk of bleeding, and arranging for transportation to and from the hospital or surgical center on the day of the procedure.

What to Expect During the Procedure?

On the day of the procedure, you will be taken to the operating room, and you may be given anesthesia to keep you comfortable during the surgery. The type of anesthesia used may vary depending on the recommendation of your healthcare provider and the specific procedure being performed.

For an open carpal tunnel release procedure, the surgeon will make a small incision in the palm of your hand. The transverse carpal ligament will be identified and carefully cut to relieve the pressure on the median nerve. The incision will be closed with sutures, and a bandage will be applied to protect the surgical site.

For an endoscopic carpal tunnel release procedure, the surgeon will make one or two small incisions in the wrist or palm. The endoscope will be inserted through one of the incisions to visualize the inside of the carpal tunnel, while specialized instruments inserted through the other incision(s) will be used to cut the transverse carpal ligament and relieve the pressure on the median nerve. The incision(s) will be closed with sutures, and a bandage will be applied.

The duration of the carpal tunnel release procedure may vary depending on the complexity of your condition and the technique used by your surgeon. Generally, the procedure takes about 30 minutes to an hour to complete.

What to Expect After the Procedure?

After the carpal tunnel release procedure, you will be monitored in the recovery area until you are awake and alert. You may experience some pain, swelling, and discomfort in the operated hand, which is normal and can be managed with prescribed pain medications. Your hand may be wrapped in a bulky dressing or a splint continue

to provide support and protect the surgical site. Your healthcare provider will provide you with instructions on how to care for the dressing or splint, as well as any activity restrictions or limitations.

You may also experience some limitations in hand function immediately after the surgery. It's common to have some temporary weakness, stiffness, or discomfort in the hand and wrist. You may need to limit certain activities, such as heavy lifting or repetitive motions, for a period of time as advised by your healthcare provider. Physical therapy or hand exercises may also be recommended to help restore strength and mobility in your hand.

During the recovery period, it's important to follow your healthcare provider's instructions for wound care, medications, and activity restrictions. You may have a follow-up appointment scheduled to monitor your progress and remove any sutures or staples that were used to close the incision.

In most cases, patients are able to resume normal activities and return to work within a few weeks after the carpal tunnel release procedure, although the timeline may vary depending on individual factors such as the type of work you do and the extent of the surgery. Your healthcare provider will guide you on when it's safe to resume your regular activities.

Potential Risks and Complications

As with any surgical procedure, there are potential risks and complications associated with carpal tunnel release surgery. These may include infection, bleeding, scarring, nerve or blood vessel injury, reaction to anesthesia, or incomplete relief of symptoms. There is also a small chance of recurrence of carpal tunnel syndrome, although it is relatively rare. It's important to discuss these risks with your healthcare provider and follow all pre-operative and post-operative instructions to minimize the risk of complications.

Conclusion

A carpal tunnel release procedure is a common surgical intervention for relieving the symptoms of carpal tunnel syndrome when conservative treatments are not effective. It can help alleviate pain, numbness, tingling, and weakness in the hand and wrist, allowing you to regain normal hand function. Understanding what to expect during the procedure, as well as the recovery process, can help you prepare mentally and physically for the surgery. Following your healthcare provider's instructions, attending all follow-up appointments, and communicating any concerns or questions you may have are important steps to ensure a successful outcome. If you suspect you may have carpal tunnel syndrome or have been recommended for a carpal tunnel release procedure, consult with your healthcare provider for a proper evaluation and personalized treatment plan.

FAQs

During the procedure, you will be under anesthesia, so you won't feel any pain. However, it's normal to experience some discomfort and pain after the surgery due to swelling and the healing process. Your doctor will prescribe pain medications to help manage the pain during your recovery.
Recovery time can vary depending on the individual and the type of procedure performed. Generally, it may take a few weeks to several months to fully recover from carpal tunnel release surgery. Physical therapy, hand exercises, and following your doctor's instructions for post-operative care can help speed up the recovery process.
You may experience some limitations in hand use immediately after the surgery due to swelling, pain, and the healing process. Your doctor may recommend wearing a splint or brace to protect your hand and wrist and limit certain activities for a period of time. It's important to follow your doctor's instructions and gradually resume normal activities as advised.
Physical therapy may be recommended as part of your recovery plan, especially if you have stiffness, weakness, or loss of range of motion in your hand and wrist. A physical therapist can guide you through exercises and techniques to help restore strength, flexibility, and function to your hand and wrist.
Carpal tunnel release surgery is generally considered a successful procedure with a high rate of symptom relief. However, the success rates can vary depending on factors such as the severity of the carpal tunnel syndrome, the technique used, and individual healing. It's important to have realistic expectations and discuss the expected outcomes with your surgeon based on your specific condition.
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