Jones The Hand
Carpal Tunnel Syndrome
What is Carpal Tunnel Syndrome?
Carpal tunnel syndrome results from a trapped nerve in the base of the palm. This nerve then malfunctions, causing symptoms of pain, numbness, pins & needles and tingling in the thumb and first three fingers. These symptoms can also go up the wrist and forearm. It is typically worse at night and wakes the patient from sleep.
If left alone, it does not usually get better unless there is a reversible cause. In most patients, there is no clear cause. If symptoms become constant or severe, the nerve can be permanently damaged leading to incurable symptoms. The muscles in the palm can become weak and wasted.
Fortunately, the condition can usually be readily treated.
Treatment
Mild cases respond well to splinting at night time. Injections can help relieve symptoms temporarily, but they usually recur when the injection wears off. The most effective treatment for moderate or severe symptoms is surgery.
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This involves cutting a tight strap in the wrist to take the pressure off the nerve. It is done under local anaesthetic as a daycase and usually only takes about 10 minutes to do, though there is some setting-up time to allow for. The wound heals in two weeks and must be kept clean and dry during this period. Dissolving stitches are normally used. The patient can return to a light job as soon as they feel able (a few days to a few weeks). Heavy work may not be possible until six weeks.
Risks and Recovery
The expected benefits of surgery are pain relief and improvement in numbness and tingling. If you are waking at night with a painful, numb hand, this usually resolves in a couple of days. The main reason for operating is to prevent the symptoms worsening and becoming permanent.
The risks include persistent symptoms, recurrence, further surgery, infection, bleeding, damage to other structures in the area, scarring, stiffness, discomfort when leaning on the hand and a rare condition where the hand can overreact to the operation resulting in pain, stiffness and swelling for many months.
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Usually patients experience a significant improvement and return to full activity within 6 weeks.
