The carpal tunnel is a passageway through the wrist carrying tendons and one of the hand’s major nerves. Pressure may build up within the tunnel
because of disease (such as rheumatoid arthritis), injury, fluid retention during pregnancy, overuse, or repetitive motions. Diabetes, alcoholism, hypothyroidism, and obesity are also all factors predisposing towards developing carpal tunnel syndrome. The resulting pressure on the nerve within the tunnel causes a tingling sensation in the hand especially the thumb, index and middle fingers, often accompanied by numbness, aching, and impaired hand function. This is known as carpal tunnel syndrome.
In some cases, splinting of the hand and anti-inflammatory medications will relieve the problem. If this doesn’t work, however, surgery may be required.
In the operation, the surgeon makes an incision from the middle of the palm to the wrist. He or she will then cut the tissue that’s pressing on the nerve, in order to release the pressure. A large dressing and splint are used after surgery to restrict motion and promote healing. The scar will gradually fade and become barely visible.
The results of the surgery will depend in part on how long the condition has existed and how much damage has been done to the nerve. For that reason, it’s a good idea to see a doctor early if you think you may have carpal tunnel syndrome.
The “classic” surgery for carpal tunnel syndrome involves an open technique where a small incision is made over the region of the ligament which compresses the median nerve. This ligament is released to decompress the median nerve. With the introduction of endoscopic surgery in other locations in the body, some hand surgeons are using a similar technique at the wrist. Usually two small incisions would be substituted for one larger incision at the wrist level. The incidence of nerve injury is slightly higher with the endoscopic surgery, but the return to work time may be slightly earlier. Because of the slight increased risk to the median and ulnar nerves associated with endoscopic carpal tunnel surgery, the majority of surgeons prefer an open technique. It is recommended that you discuss in detail these two types of surgery with the particular surgeon you have chosen to do your surgery. Also see Nerve Compression