Carpal Tunnel Syndrome - Treatment

Carpal Tunnel Syndrome

If the symptoms are mild the use of a splint can provide some relief, especially if worn at night. The splints are designed to keep the wrist in a neutral position. This may reduce the pressure in the carpal tunnel and relieve or prevent worsening of the symptoms.

A cortisone injection into the carpal tunnel will probably relieve the symptoms, but this is often only temporarily.

The definitive treatment is surgery. If this is performed you will be admitted to hospital as a day case patient and taken to theatre for the operation, which is usually carried out under local anaesthetic. A tourniquet will be placed around your arm and a small cut from the wrist crease to the palm is made. An incision is then made into the fascia (roof of the carpal tunnel) this small cut instantly increases the tunnel volume by 25%, relieving the pressure on the median nerve. The skin is then stitched and the hand is bandaged so that the fingers and thumb are left free.

With a Carpal Tunnel Release any intermittent symptoms such as pain disturbing sleep will go immediately. If the fingers are numb before the operation then recovery of feeling can take several months and may never occur.

Whilst in hospital your arm will be elevated. Patients may need simple painkillers for the first 24 hours.

In just a few weeks new fascia will grow to fill the gap of the enlarged carpal tunnel.

POST-OPERATIVE CARE

At home the bandages should be removed after 2 days, but the dressing over the stitches should remain and be kept clean and dry. Stitches are removed after 12 to 14 days. Until then heavy use of the hand should be avoided, but light use including driving can commence after a few days.

At the post-operative appointment the wound will be checked and the stitches removed. Exercise advice will be given to help maintain circulation and improve range of motion and strength. You will be advised that even though you can return to normal tasks straight away, you may have a tender scar for a couple of months. Massaging it twice a day with moisturising cream will alleviate sensitivity.

POTENTIAL COMPLICATIONS: Scar tenderness, wound infection, aching either side of the scar (called pillar pain), injury to small nerve branches and failure to relieve the symptoms.

      

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