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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

  1. Infection may require antibiotics
  2. Bleeding
  3. Damage to a nerve (may cause numbness or rarely, require another operation)
  4. 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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Dr Warrier, Surgery, Laparoscopy, Colonoscopy,  Endoscopy   Dr Warrier, Surgery, Laparoscopy, Colonoscopy,  Endoscopy