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Carpal Tunnel Surgery - Recovery time, Procedure, Cost, Pictures, Complications

Updated on July 10, 2014

Pictures

What is Carpal Tunnel Surgery?

Carpal tunnel surgery is the treatment indicated to relieve the pressure on the median nerve in Carpal tunnel syndrome. The method of treatment is recommended when the patient remains unresponsive with the non-surgical treatment and when the symptoms remain persistent and severe.

There are different reasons for carpal tunnel surgery to be recommended by doctors and the reasons include the following:

  • Patient remains unresponsive to non-surgical treatment or where there is no proof of relief from the symptoms of the syndrome.
  • Carpal tunnel syndrome is confirmed after the electromyography test.
  • Presence of severe pinching of the median nerves which can result in a decrease in the size of the affected hand and wrist.
  • The symptoms persist longer or for more than six months without any relief.

Carpal tunnel syndrome is a progressive condition that involves the hand and the wrist and is characterized by pain, numbness and tingling sensation over the affected area as brought by pinching of the median nerve. The syndrome is non-life threatening but can significantly affect the quality of life as it can result in limited movement of the affected hand and wrist.

Carpal tunnel syndrome occurs when there is an increased pressure on the median nerve at the wrist brought by the swelling of the carpal tunnel that leads to the compression of the median nerve of the wrist. The median nerve can be aggravated when there is the presence of swelling and any changes in the position of the tissues of the median nerve. The aggravation or irritation thus results in the symptoms of the syndrome such as tingling, numbness and progressive pain.

Procedure

The surgical procedure for carpal tunnel syndrome is called "carpal tunnel release". It is a surgery that basically puts a patient under local anesthesia and on an out-patient basis. The method of carpal tunnel release is performed with either two of its types. The traditional type of carpal tunnel surgery is called the open carpal tunnel release while the newer method is called the endoscopic carpal tunnel release.

Whatever the method, carpal tunnel surgery is generally performed to relieve the pressure that has built up in the carpal tunnel and that compresses the median nerve. A carpal tunnel is a tunnel like structure that runs from the hand to the wrist and is covered by the transverse carpal ligament. The purpose of carpal tunnel is to protect the median nerve that functions in controlling the feeling of the palm on the side of the thumb, long finger and the index finger. The median nerve is brought to compression when an inflammation within the carpal tunnel is present or if any changes in the position of the tissues in the median nerve. The two types of carpal release however, have the same purpose which is to cut the transverse carpal ligament to release the pressure on the median nerve thereby relieving the symptoms of carpal tunnel syndrome.

Open carpal tunnel release

This is the traditional method of performing the carpal tunnel release. The procedure requires an opening at the base of the palm and generally takes a longer period of recovery following surgery.

After pre-operation procedure has been performed, the patient in open carpal tunnel release is put under local anesthesia. A small incision about an inch in length or may be slightly longer is made at the base of the palm of the hand. The incision will allow the transverse carpal ligament to become visible and allow the surgeon to proceed with the procedure to cut through and release the carpal ligament to make more room for the median nerve. The cut in the skin at the base of the palm of the hand is then close leaving the gap of the carpal tunnel unstitched as it will eventually fill up with scar tissue. The site is then wrapped up after the cut has been stitched up.

Endoscopic carpal tunnel release

This is the new method of carpal tunnel release. It is a minimally invasive technique that requires only a small incision either with single-portal technique or with two-portal technique.

The patient is put under local anesthesia and afterwards, a small incision is made to provide a passageway for the endoscopic camera to serve as a guide in cutting through the ligaments. The incision site is usually at the base of the palm of the hand which is then stitched close after the carpal tunnel has been released with the gap left unstitched as it will eventually fill up with scar tissues.

Cost

The cost of carpal tunnel surgery varies widely and depends on where the procedure is done. The cost is also dependent on the type of the hospital and the geographic location of the hospital. The cost is also broken down into several services provided such as a physician service, anesthesia service and hospital service. The geographic location on the other hand also influences the cost of surgery in terms of the facilities or the modernity of the facilities being used.

Complications

Just like any other type of surgery, carpal tunnel surgery also carries several complications which may be inevitable although it depends on how well the patient takes care of the incision site and how well the surgeon did the procedure.

Both types of carpal tunnel release however carry low rates of complications and risks following the surgery. The risk of possible infection on the hand is the major complication that can occur following carpal tunnel release, although this seldom happens.

Recovery time

Open carpal tunnel surgery usually requires a longer period of recovery or about one to two weeks before the patient can resume normal activities of the hand. Heavy use of affected hand is not advised for up to 3 months or until full recovery.

Endoscopic carpal tunnel release takes a shorter period of recovery compared with open carpal tunnel release. The symptoms may be relieved right after surgery or may also take several weeks while heavy use of the affected hand is not advised for a period of two weeks and until full recovery has been achieved.

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