Carpal Tunnel

Carpal tunnel syndrome symptoms include:

• Tingling or numbness in the fingers or hand
• A sensation like an electric shock in the fingers
• Weakness in the hand

The median nerve runs from the forearm through a passageway in the wrist (carpal tunnel) to the hand. It provides sensation to the palm side of the thumb and fingers, except the little finger. It also provides nerve signals to move the muscles around the base of the thumb.

Anything that squeezes or irritates the median nerve in the carpal tunnel space may lead to carpal tunnel syndrome.

The most important diagnostic test is a nerve conduction study. This test determines whether the electrical signals travel along various nerves at the expected speed and whether the whole signal is transmitted or only part of it. Patients with carpal tunnel syndrome will have abnormal nerve conduction results for the median nerve at the level of the wrist. Patients without these results are unlikely to have carpal tunnel syndrome, and other diagnoses should be considered.

It is essential to treat carpal tunnel syndrome as early as possible after symptoms start. In the early stages, it is advised that patients rest their hands, avoid activities that aggravate their symptoms and apply cold packs to reduce swelling.

Other treatment options include wrist splinting, medications and surgery. Splinting and other nonsurgical treatments are more likely to help if you have mild to moderate symptoms. Surgery may be appropriate if symptoms are severe.

Carpal tunnel surgery aims to relieve pressure by cutting the ligament pressing on the median nerve. Dr Shiva will make an incision in the palm over the carpal tunnel and cuts through the ligament to free the nerve.

During the healing process after the surgery, the ligament tissues gradually grow back together while allowing more room for the nerve. This internal healing process typically takes several months, but the skin heals in a few weeks. Soreness or weakness may take several weeks to a few months to resolve after surgery.

Postoperative care

• Keep arm elevated for 72 hours post-surgery using either a pillow or sling
• Keep the wound dry for five days. Then dressings can be removed
• Suture removal for carpal tunnel release with GP at ten days
• Actively move fingers throughout your recovery
• Monitor for any wound redness, discharge, fevers
• Six-week review with Dr Shiva