Carpal Tunnel Syndrome

The carpal tunnel is located at the base of your hand. Through the tunnel travels your median nerve. Your median nerve is one of the main nerves to your hand and allows you to bend your fingers and feel sensation.

The carpal tunnel is a narrow passage and when pressure is placed on the tunnel, it in turn puts pressure on the median nerve. The compression can be caused by injury, rheumatoid arthritis, a fractures and sprains, repetitive motion of hands and wrist, hormonal imbalances or by an underlying medical condition such as diabetes, gout or a cyst in the canal. Carpal Tunnel Syndrome typically start gradually with a vague aching in your wrist that can extend to your hand or forearm. Other common symptoms are tingling, numbness, pain and, eventually, hand weakness. Carpal tunnel syndrome can be treated using conservative treatment or surgery.

The conservative treatments include:

• Treating underlying medical conditions
  
• Resting the hand for 2 weeks or more
  
• Avoid activities that tend to worsen the symptoms
  
• Ice packs to avoid swelling
  
• Medications such as non-steroidal anti-inflammatory drugs, diuretics, and steroid injections.
  
• Immobilising the hand and wrist with a splint or wrist brace for 4-6 weeks
  
• Strengthening and stretching exercises once symptoms diminish

If conservative treatment options fail to resolve the condition your surgeon may recommend surgical procedure.

Carpal Tunnel Release Surgery

In most cases, carpal tunnel surgery is done as a day procedure. During surgery, a small incision is made in your palm. The roof (transverse carpal ligament) of the carpal tunnel is divided. This increases the size of the tunnel and decreases pressure on the nerve. Once the skin is closed, the ligament begins to heal and grow across the division. The new growth heals the ligament, and allows more space for the nerve and flexor tendons.

After surgery, there will be a compression dressing covering your hand. A splint may be used to support your hand and wrist. Generally the procedure takes around 30 minutes.

Post-operative instructions:

• Elevate the hand to reduce swelling
  
• The sling may be removed at night to sleep
  
• Apply ice packs to the surgical area to reduce swelling
  
• Take analgesics to relieve any pain
  
• Keep the wound clean and dry until your stitches are removed
  
• Physiotherapy may be advised to restore wrist strength
  
• Eating a healthy diet and not smoking will promote healing

The majority of patients suffer no complications following carpal tunnel release surgery. However some patients may suffer from pain, infections, scarring, and nerve damage causing weakness, p paralysis, or loss of sensation and stiffness in the hand and wrist area. If you have any problems or concerns contact your surgeon, GP or nearest Emergency Dept.