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.

How is a Carpal Tunnel release procedure carried out?

A Carpal Tunnel Release can be performed under General Anaesthetic or Regional Anaesthetic (you will be awake). 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.

How long do I have to be hospitalized?

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 joint stiffness and other complications such as Deep Vein Thrombosis (DVT) from developing. Following a progressive improvement of mobility and pain control patients are normally discharged from hospital 24 hours following surgery. By the time the required level of recovery is achieved for discharge, patients are normally fully mobile, wearing a light weight dressing and support sling on the effected hand, eating and drinking normally and taking only mild analgesia (pain killers).

Recuperation

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.

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