Why get carpal tunnel surgery?
Carpal tunnel syndrome is also called median nerve entrapment, referring to the median nerve that runs along your forearm into your wrist and becomes compressed because of swollen tissue.
Your carpal tunnel is a narrow funnel in your wrist that protects your median nerve. Sometimes the tissue inside that tunnel can swell, press against your median nerve and cause pain. This is what causes carpal tunnel syndrome.
People suffering from carpal tunnel syndrome might notice numbness or tingling in their hands and wrists. You might experience sharp, piercing pain at work or find it difficult to comb your hair in the morning.
Carpal tunnel surgery is generally an option after you've exhausted other more conservative medical therapy. Before getting the surgery, your doctor might first recommend you wear a splint and use anti-inflammatory drugs to reduce the pain. You might also be given a list of exercises to do to help alleviate some of the problems. If this doesn't work, surgery might be the next option.
Insurance generally covers carpal tunnel surgery when it's found to be medically necessary.
What happens when you get carpal tunnel surgery?
Before you get the surgery, your doctor will run a few tests to determine whether your carpal tunnel syndrome is severe enough to call for surgery.
For your carpal tunnel surgery, your doctor will likely perform the surgery either endoscopically, using a small camera and small incisions, or an open surgery, making about a two-inch incision. It is typically an outpatient surgery performed either by numbing the area or placing you under general anesthesia, meaning you're asleep for the procedure.
During an open surgery, your surgeon will make a small incision on your palm. Once inside, your surgeon will cut a ligament in your wrist known as the carpal ligament. This creates more room for the median nerve, which helps you move all of your fingers except your little finger. In some cases, your surgeon might use a microscope to clean up the outside of the nerve.
While your wrist heals, your ligament tissues will generally grow back but leave more room for the median nerve.
Does it hurt?
You most likely won't feel anything during the surgery. Afterward, your doctor might prescribe medication to alleviate some of the pain and recommend that you elevate your hand above your heart to reduce swelling. You might experience some swelling and stiffness in your hand and wrist after the surgery. You might also be required to wear a wrist brace after the surgery.
What are the risk factors?
The risks of carpal tunnel surgery will vary from patient to patient and depend on whether you suffer from other medical problems.
With any surgery, there's a risk you'll have a reaction to the anesthesia and also risk of infection and bleeding. There's also a risk that your surgeon will damage nerves or tendons.
Depending on how severe your symptoms were, there's also a risk that you might not get better. Many carpal tunnel patients do recover, but results will vary from patient to patient.
Because of hand hygiene issues, you usually only have one hand operated at a time. Performing carpal tunnel surgery on both hands can increase the rate of infection.
What's the recovery time?
It can take a couple of months to fully recover from carpal tunnel surgery and feel full function again.
You'll be allowed to go back to work on light duty after a few days. If you have an office job, it's important to understand what restrictions you have on how much you can type and use a computer.
You'll get your stitches out about two weeks after the surgery. After about three weeks, you'll be allowed to get your hands around dirty environments. A carpal tunnel patient is sometimes sent to physical therapy to help with the recovery process.
It's important to listen to your doctor's recommendations in your recovery. For example, your doctor might suggest you perform exercises to help strengthen the muscle. It's also important to ask anything questions you might have before and after the surgery and be honest with your doctor about any concerns you have.
What's the follow-up?
Your doctor will likely want to see you a week or two weeks after the surgery to see how you're recovering. You might also go in about a month after surgery. It's rare to undergo a second carpal tunnel surgery on the same hand.
Sources: Dr. Mehdi Adham, a plastic and reconstructive surgeon at Southwest Orthopaedic and Reconstructive Specialists; The Mayo Clinic; The National Institutes of Health; National Institute of Neurological Disorders and Stroke; American Academy of Family Physicians; The American Academy of Orthopaedic Surgeons.