Carpal Tunnel Syndrome St. Louis
Median Nerve Compression
Carpal tunnel syndrome is a disorder whereby one of the main nerves to the hand, the median nerve, is compressed at the wrist level as it passes through a narrow tunnel along with several tendons. This leads to a variety of symptoms and patients may complain of weakness or aching in the hands, numbness or tingling in the fingers, and sometimes pain or discomfort awakening them at night. Many factors can contribute to this phenomenon, including arthritis, pregnancy, and overuse or repetitive motions. Patients suffering from diabetes, obesity, and thyroid disease may be at increased risk of developing carpal tunnel syndrome. Prolonged compression of the median nerve leads to a slowing of the nerve signals, and if severe it can even cause irreversible death of the nerve fibers. A carpal tunnel release will make more room for the nerve so it can begin the recovery process. Nerve fibers that were slowed will recover an estimated 1 millimeter a day, or 1 inch per month. Fibers that have been irreversibly damaged may not recover and in this case, the release helps salvage the remaining nerves.
During your consultation one of our surgeons will discuss your symptoms, aggravating factors, and evaluate your current hand function. X-rays of the hands will be taken, and often nerve conduction studies will be ordered to measure the function of the main nerves in your arms. Sensory and strength testing will be performed and a discussion will be had on the best approach for your particular case. This may include wrist splints to help prevent kinking of the nerve, which should be worn throughout the day and night. Anti-inflammatory medications may be recommended, or even a steroid injection into the affected area. Patients with more severe compressions or those that do not improve with more conservative measures may be offered carpal tunnel release surgery.
- Length: 30 minutes
- Anesthesia: Local, sedation, or general anesthesia
- Outpatient, same day surgery
- Recovery: 2 weeks
- Side Effects: Palm sensitivity, tenderness, bruising, swelling
CARPAL TUNNEL RELEASE CAN:
- Relieve nerve compression at the wrist
- Allow intact nerve fibers to recover
- Prevent ongoing nerve death
- Improve finger sensation
- Improve hand strength
PREPARING FOR CARPAL TUNNEL RELEASE
Smoking and all forms of nicotine should be stopped at least 2 weeks prior to any surgery.
This includes e-cigarettes, patches, and gum.
Any medications and supplements which cause an increased risk of bleeding should also be stopped 2 weeks prior to any major surgery. Please see our list of medications and supplements to avoid. As always, make sure to check with your doctor before stopping any medications.
CARPAL TUNNEL RELEASE TECHINQUE:
Our surgeons perform the open carpal tunnel release through a limited incision in the base of the palm. This allows the best visualization, ensuring the utmost safety for all patients including those with anatomical variants. The procedure is often done with light sedation administered by our expert team of anesthesiologists, supplemented with additional numbing medication injected into the palm. Patients can elect to avoid sedation or have a general anesthetic for the procedure as well. After the carpal tunnel release, sutures will be placed followed by a soft splint. Patients keep this splint on for the first week to help protect the repair. After the first visit, our surgeons will start their patients on nerve gliding exercises to optimize recovery.
RECOVERY FROM CARPAL TUNNEL RELEASE
Patients can return home after surgery. A postoperative soft splint is worn for 1 week until the first follow-up. After that time patients will be instructed on special nerve gliding exercises. Sutures are removed in 3 weeks, and tapping on the palm is encouraged to minimize any sensitivity in the area. Most patients can return to work in 1-2 weeks, but those with occupations requiring heavy lifting and gripping may need some additional time away to recover.
FREQUENTLY ASKED QUESTIONS
Do you Have a Question?
Q: I HAVE CARPAL TUNNEL SYNDROME IN BOTH HANDS. CAN I HAVE THEM FIXED AT THE SAME TIME?
A: Although technically feasible, our surgeons like to stage the two procedures, waiting approximately 4-6 weeks between each release. This ensures his patients always have at least one good hand to perform normal daily functions such as eating, bathroom hygiene, etc.
I HAD NERVE CONDUCTION STUDIES PERFORMED 2 YEARS AGO. ARE THESE STILL VALID?
Unlikely. It is best to have updated information, preferably within the past 6 months. Depending on your exam and symptoms, our surgeons may recommend these be repeated.