Our hands are a complex system of bones, muscles, and ligaments working in tandem to allow us to perform our everyday tasks. They allow us to grip hard enough to hold heavy objects and gently enough to handle fragile objects like eggs. Our hands connect with others when we type an email, send a text with our phones, and when we hold hands with a loved one. Sometimes, however, our repetitive movements can cause strain on the nerves on our hands, leading to carpal tunnel.
What is it and what are the symptoms?
Carpal tunnel is caused by the compression of the hand’s median nerve and is characterized by pain, numbness and tingling in the hand and arm. Mild symptoms of carpal tunnel can be relieved without surgery, but when carpal tunnel becomes severe, surgery is often used to relieve the pressure on the nerves. When carpal tunnel becomes severe, it can cause weakness and loss of range of motion or ability to grip in sufferers.
Risk Factors
While carpal tunnel can be a result of repetitive motions and wrist positioning, it can also be influenced by other factors. Heredity, pregnancy, and other health conditions like diabetes, arthritis, and thyroid imbalances can all contribute to the development of carpal tunnel.
Treatment of Severe Carpal Tunnel Through Surgery
Severe carpal tunnel is treated through a surgery called ‘carpal tunnel release’ in which a surgeon relieves pressure on the nerve by opening up the nerve tunnel. They do so by cutting the ligament in the hand, which increases the size of the tunnel and relieves pressure on the nerve. There are two types of carpal tunnel release surgery.
The first of these is ‘open carpal tunnel release’ where the doctor cuts into the palm of the patient in order to view their ligament. While there is a debate on whether Halogen vs LED Lights are better for providing light to the surgeon, either of these medical grade lights is sufficient for viewing the ligament.
In ‘endoscopic carpal tunnel release’ a doctor cuts two holes in the patient’s hand and uses a camera to view the ligament they are cutting.
Both surgeries are outpatient surgeries and can be performed under a general or localized anesthetic depending on the patient.
Recovery
A patient’s recovery from carpal tunnel release surgery can take anywhere from a few weeks to a year. After the surgery is performed, the patient will be advised to elevate their hand above their heart to prevent swelling. Pain, swelling, and soreness are to be expected in the immediate days following the surgery. Sometimes the soreness lasts for a couple of weeks, but it can last for up to a few months.
The patient will be advised to wear a brace for several weeks after the surgery and limit their activity so that their hand can heal. Within two to three months, their grip and ability to pinch should return, but this can take up to six to twelve months.
Treatment of Mild Carpal Tunnel
If caught early enough, mild carpal tunnel can be treated without surgery. The symptoms can be relieved in several ways ranging from activity changes to medicine. Bracing the hand to relieve pressure on the nerve is a common treatment, and over the counter pain relievers such as ibuprofen are recommended to relieve pain, though steroid injections of cortisone, an anti-inflammatory, are also sometimes recommended. Nerve gliding exercises and stress balls can also naturally relieve pressure.
If a patient notices carpal tunnel symptoms, such as pain or tingling in their hands, it is recommended that they change or modify their activities, or alter their workstation. It is best to visit a doctor at the onset of these symptoms so that they do not develop into more severe carpal tunnel which could necessitate surgery.
With treatment, the symptoms of carpal tunnel can be relived almost entirely, but it is possible for carpal tunnel to reoccur even after surgery. Because of this, it is important to continue with any modifications or therapy techniques, even after symptoms are relieved.
