Carpal Tunnel Syndrome
Carpal tunnel syndrome is a very common hand condition that can affect people of all ages. Middle aged and elderly people are more commonly affected. It is also more common in women. Pain, numbness and tingling in your hand may be from carpal tunnel syndrome. Carpal tunnel syndrome happens when the area around the main nerve to your hand is too tight causing nerve compression. The nerve is called the median nerve and the small space in your wrist where it passes is called the carpal tunnel. Carpal tunnel is the most common type of peripheral entrapment neuropathy.
When the median nerve is compressed, due to thickening of the ligament that roofs in the carpal tunnel, symptoms in the hand can develop. Symptoms of carpal tunnel syndrome include, pain, numbness tingling and weakness in your hand and fingers. These symptoms are often worse at night and can be relieved by elevating or shaking your hand. Carpal tunnel syndrome primarily effects the thumb, index and middle fingers, although pain may radiate up the arm.
In most cases the cause for carpal tunnel syndrome is unknown. In some patients the syndrome can be due to trauma, repetitive work involving the hand and wrist, pregnancy, thyroid conditions, diabetes or other causes.
When the median nerve is compressed, due to thickening of the ligament that roofs in the carpal tunnel, symptoms in the hand can develop. Symptoms of carpal tunnel syndrome include, pain, numbness tingling and weakness in your hand and fingers. These symptoms are often worse at night and can be relieved by elevating or shaking your hand. Carpal tunnel syndrome primarily effects the thumb, index and middle fingers, although pain may radiate up the arm.
In most cases the cause for carpal tunnel syndrome is unknown. In some patients the syndrome can be due to trauma, repetitive work involving the hand and wrist, pregnancy, thyroid conditions, diabetes or other causes.
Carpal Tunnel Pre-Op Explainer Video
Video Courtesy of Nebula Health
A simple non invasive test, called a nerve conduction study, will accurately diagnose carpal tunnel syndrome. This test is performed by a neurologist and can determine if your symptoms are caused by compression of the median nerve in the carpal tunnel. The nerve conduction test can also determine the severity of the compression. If severe compression is left untreated for a long period of time the median nerve may be permanently damaged leading to chronic symptoms.
The initial treatments for carpal tunnel syndrome are non-operative therapies and include:
When symptoms are severe, or do not respond to the above simple treatments, surgery is a safe option for relief of your carpal tunnel syndrome. Surgery involves decompressing the median nerve in the carpal tunnel by dividing the thickened ligament above the nerve. For more information about surgery for carpal tunnel syndrome see below.
Watch the video below to learn more about carpal tunnel syndrome.
The initial treatments for carpal tunnel syndrome are non-operative therapies and include:
- rest
- medications - such as anti-inflammatories or steroids
- treatment of the underlying disorder - such as hypothyroidism or diabetes management
- splinting of the wrist
- hand therapy
- physiotherapy
- steroid injection
- avoidance of behaviours which aggravate symptoms
When symptoms are severe, or do not respond to the above simple treatments, surgery is a safe option for relief of your carpal tunnel syndrome. Surgery involves decompressing the median nerve in the carpal tunnel by dividing the thickened ligament above the nerve. For more information about surgery for carpal tunnel syndrome see below.
Watch the video below to learn more about carpal tunnel syndrome.
Video - Carpal Tunnel Syndrome
Surgery for Carpal Tunnel Syndrome - Carpal Tunnel Decompression
Carpal tunnel decompression is a small surgical procedure used to treat the pain and numbness of carpal tunnel syndrome. More than 90% of patients will have an excellent outcome following carpal tunnel decompression with significant improvements or relief of symptoms. The surgery relieves pressure on the median nerve as it travels through the carpal tunnel in your wrist.
The surgery is generally performed as a day case. It can be performed under local anaesthesia or general anaesthesia, depending on your health and preference.
A small 1-2cm incision is made in the middle of your wrist over the median nerve. The thick ligament over the nerve is divided to release pressure on the nerve. Small sutures are then placed in the skin to close the wound. The procedure generally takes 10-30 minutes to complete and is well tolerated by most patients. You will have a dressing over your hand following the surgery.
Dr Oehme has extensive experience in performing surgery for carpal tunnel. Watch the video below to learn more about surgery for carpal tunnel syndrome.
The surgery is generally performed as a day case. It can be performed under local anaesthesia or general anaesthesia, depending on your health and preference.
A small 1-2cm incision is made in the middle of your wrist over the median nerve. The thick ligament over the nerve is divided to release pressure on the nerve. Small sutures are then placed in the skin to close the wound. The procedure generally takes 10-30 minutes to complete and is well tolerated by most patients. You will have a dressing over your hand following the surgery.
Dr Oehme has extensive experience in performing surgery for carpal tunnel. Watch the video below to learn more about surgery for carpal tunnel syndrome.
Video - Carpal Tunnel Surgery
Risks of Carpal Tunnel Surgery
More than 90% of patients will have an excellent outcome following carpal tunnel decompression with significant improvement or relief of symptoms. 1-2% of patients may suffer a significant or permanent complication including:
- Wound infection 1%
- Painful wound
- Scare formation
- Damage to the median nerve, or one of its branches, causing pain, pins and needles, loss of feeling or weakness in the hand and thumb.
- Painful neuroma formation
- Significant bleeding from damage to the palmar arterial arch
- Complex regional pain syndrome (RSD) - 0.3%
- Persistence or worsening of symptoms
- Tendon injury
