Carpal and Cubital Tunnel Release
Affecting more than 12 million people, carpal tunnel syndrome can cause pain, numbness, and tingling in the hand and arm. It occurs when the median nerve, one of the major nerves in the hand, is compressed as it travels through the carpal tunnel in the wrist.
Carpal tunnel syndrome may be treated surgically through a procedure called carpal tunnel release, which relieves pressure on the median nerve by cutting the transverse carpal ligament. Traditional carpal tunnel release procedures can remedy the condition.
Doctors used to think that carpal tunnel syndrome was caused by an overuse injury or a repetitive motion performed by the wrist or hand, often at work. They now know that it’s most likely a congenital predisposition (something that runs in families) – some people simply have smaller carpal tunnels than others. Carpal tunnel syndrome can also be caused by injuries, such as a sprain or fracture, or repetitive use of a vibrating tool. It’s also been linked to pregnancy, diabetes, thyroid disease, and rheumatoid arthritis.
The median nerve and tendons that allow your fingers to move pass through a narrow passageway in the wrist called the carpal tunnel. The carpal tunnel is formed by the wrist bones on the bottom and the transverse carpal ligament across the top (or inside) of the wrist. When this part of the body is injured or tight, swelling of the tissues within the tunnel can press on the median nerve. This causes numbness and tingling of the hand, pain, and loss of function if not treated. Symptoms usually start slowly and may get worse over time. They tend to be worse on the thumb side of the hand.
A diagnosis of carpal tunnel syndrome is about the only reason to have carpal tunnel surgery. And even then, your doctor will likely want you to try nonsurgical treatments first. These may include over-the-counter pain medicines, physical therapy, changes to the equipment you use at work, wrist splints, or shots of steroids in the wrist to help relieve swelling and pain.
The reasons that a doctor would recommend a carpal tunnel release surgery may include:
- The nonsurgical interventions for carpal tunnel syndrome don’t relieve the pain.
- The doctor performs an electromyography test of the median nerve and determines that you have carpal tunnel syndrome.
- The muscles of the hands or wrists are weak and becoming smaller because of the severe pinching of the median nerve.
- The symptoms of carpal tunnel syndrome have lasted 6 months or longer with no relief.
During a CTR, a surgeon cuts through the ligament that is pressing down on the carpal tunnel. This makes more room for the median nerve and tendons passing through the tunnel and usually improves pain and function.
The recovery from carpal tunnel surgery takes time – anywhere from several weeks to several months. If the nerve has been compressed for a long period, recovery may take even longer. Recovery involves splinting your wrist and getting physical therapy to strengthen and heal the wrist and hand.
There may be other risks, depending on your specific medical condition. Be sure to discuss any concerns with your doctor before the procedure.
How do I get ready for carpal tunnel surgery?
- Tell your doctor about all medicines you are currently taking, including over-the-counter drugs, vitamins, herbs, and supplements.
- You will probably need to stop taking any medicines that make it harder for the blood to clots, such as ibuprofen, aspirin, or naproxen.
- If you’re a smoker, try to quit before the surgery. Smoking can delay healing.
- You may need to get blood tests or an electrocardiogram (ECG) before surgery.
- You will usually be asked not to eat or drink anything for 6 to 12 hours before the surgery.
Based on your medical condition, your doctor may request other specific preparations.
What to Expect
Carpal tunnel release is usually an outpatient procedure, which means that you can go home the same day as the surgery if all goes well. There are 2 types of carpal tunnel release surgery. The traditional method is the open release, in which the surgeon cuts open the wrist to do the surgery.
The cost of carpal tunnel release surgery is based on several considerations. This can include both the extent of the procedure and a patient’s insurance carrier. Medicare will cover carpal tunnel release surgery if it is deemed necessary treatment. BEST accepts Medicare, most private health insurances, and works with workers’ compensation claims and personal injury cases at all of our centers.
Find Lasting Relief from Carpal Tunnel Syndrome
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