CARPAL TUNNEL
What is the carpal tunnel?
Just
beyond the wrist, a small tunnel is created by the bones of the hand and
ligaments attached to it. A big nerve of the hand, called the median
nerve, travels through this tunnel. When there is inflammation in this
area, such as with tenosynovitis, the nerve can get compressed causing
symptoms of numbness and pins and needles in the hand (Carpal Tunnel
Syndrome).
How is carpal tunnel syndrome treated?
Carpal
tunnel syndrome is treated by non-surgical means (splints,
anti-inflammatory drugs, steroid injections) or surgery. Surgery is
recommended if the condition has been prolonged, if symptoms are severe
or if non-surgical treatment is ineffective.
Carpal tunnel release
Surgery involves cutting the ligament that lies over the tunnel to
relieve the pressure on the nerve. The operation can be performed under
local or general anaesthetic. A local anaesthetic is an injection that
numbs an area of skin so that you do not feel pain during the
procedure. The local anaesthetic will not make you sleepy. A general
anaesthetic will put you to sleep for the duration of the procedure.
After the procedure
If the
procedure is done under local anaesthetic, you will be free to go home
soon after. As the local anaesthetic wears off, you may require
painkillers. The pain should settle in a few days, however, the pins
and needles may remain for a few weeks. During the initial recovery
period, it is important to keep your hand elevated. Your doctor will
also suggest various exercises for you to do in order to promote healing
and prevent swelling and stiffness. You may commence light duties early
and start driving after you have regained strength in your hand and
fingers. Fully recovery may take a few months.
The
stitches will need to be removed by Dr Warrier at a time specified,
usually one to two weeks after the procedure.
Complications
As
with any operation, there are risks associated with Carpal tunnel
release. The potential complications are
-
Infection – may require antibiotics
-
Bleeding
-
Damage to a nerve (may cause numbness or rarely, require another
operation)
-
Recurrence – rare (occurs in 1%); symptoms may persist if the
ligament has not been cut completely and need a re-operation.
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