What is carpal tunnel syndrome?
Carpal tunnel syndrome is a fairly common condition that occurs when there is too much pressure on a nerve in the wrist.
The nerve enters the wrist through a narrow channel made of bones and a ligament, called the carpal tunnel. Because there isn’t much room in the tunnel, any swelling of the tissue in or around the carpal tunnel can compress the nerve, causing tingling, numbness or pain in your hand, wrist and forearm.
Surgery is needed if medicines or wrist splints have failed to relieve pain, or if your symptoms continue to get worse.
The operation is usually done under a local anaesthetic, which means that your wrist and hand will be completely numb but you stay awake.
The procedure is routinely performed as a day-case, with no overnight stay. Your surgeon will explain the benefits and risks of having carpal tunnel surgery, and will also discuss the alternatives to the procedure.
About the operation
There are two main types of surgery - open and keyhole. Your surgeon will discuss which technique is appropriate for you.
Open surgery
A single cut (about 5cm long) is made in the front of the wrist at the base of your palm. Your surgeon opens the carpal tunnel and cuts the ligament to relieve the pressure on your nerve.
Keyhole surgery
A small cut (about 2cm long) is made in your forearm just above the wrist or in the palm of your hand. A thin flexible telescope (endoscope) is passed into the cut to help see inside the wrist either by looking directly through this, or at pictures it sends to a video screen. Using a special instrument attached to the endoscope the ligament is cut.
After surgery, the skin cut is usually closed with dissolvable stitches. The operation can take 10 to 20 minutes.
The operation to relieve carpal tunnel syndrome is a commonly performed and generally safe procedure. However, all operations carry risks as well as benefits.
Complications specific to carpal tunnel surgery include a small risk of injury to other nerves, blood vessels or tendons in the hand.
Most people have little or no pain and numbness in their hand after surgery, but for some people it can take several months for discomfort to disappear.
In some cases, the symptoms of carpal tunnel syndrome can return, or you may experience a temporary loss of strength when pinching or gripping objects.
The chance of complications depends on the exact type of operation you are having and other factors such as your general health. Ask your surgeon to explain in more detail how any risks apply to you.
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