Tunnel syndrome surgery

Development of carpal tunnel syndrome

Around the wrist, the median nerve and the muscles, tendons, blood vessels and bony formations that run around it, make up the area known as the carpal tunnel. This tunnel is formed by the U-shape of the hand bones and the bridging ligament. When the nerve is compressed and the tunnel narrows, numbness and later pain develop in the hand.

The development of tunnel syndrome can be aggravated by occupations that put a lot of strain on the wrist and elbow, strenuous activity, diabetes, injuries and, temporarily, pregnancy. The development of Carpal tunnel syndrome is more common in the dominant hand, but can sometimes occur in both hands.

Symptoms of tunnel syndrome

In the early stages of tunnel syndrome, the first symptoms are unpleasant tingling and numbness. The symptoms are typically felt in the first three fingers of the hand, but do not affect the little finger or ring finger. The unpleasant tingling, numbness is felt in the fingers and the thumb side of the palm. The symptoms are caused by swelling in the carpal tunnel, which leaves less space for the median nerve. This puts pressure on the median nerve and causes the area around it to become numb.

Initially, symptoms usually occur only at night, because the tendons do not move at night, they become more lodged in the tunnel and put more pressure on the median nerve. This often results in sleep disturbance, but as time goes on, numbness also appears during the day.

In the absence of appropriate treatment may cause severe, burning pain around the wrists and in the fingers, which can become permanent over time, and then can radiate out the whole arm. The grip of the fingers and palm loosens, the muscles of the palm and the pad of the thumb start to atrophy, causing the hand to become clumsy. The fine movements of the thumb, index and middle fingers also deteriorate. The longer you wait to treat, the more damage is done to nerves, muscles, tendons and soft tissues.

Treatment of tunnel syndrome

In the early stages, the hand surgeon may suggest various conservative (non-surgical) treatments. The most common options are wrist splinting, rest, physiotherapy, and, in some cases, steroid injection. At a moderately advanced stage, steroid injections may be considered. If conservative treatment fails or the diagnosis is made at an advanced stage of the disease, surgical release of the nerves is recommended.

Recovery time after tunnel syndrome surgery

The first post-operative check-up is 1-2 days after the operation, during which the specialist removes the blood drainage tube (drain) from the operated hand. Suture removal is due 7-14 days after the operation, fter which, physiotherapy and ultrasound scar treatment may be recommended. If the condition has affected hand function, occupational therapy may be recommended after surgery for a full recovery. During the rehabilitation days, it is recommended to take larger amounts of Vitamin B which helps the nerves to regenerate. The total recovery time is about two months.

Why is carpal tunnel syndrome surgery important?

The uncomfortable night-time tingling and numbness in the hand and fingers is often ignored in the early stages. However tunnel syndrome is characterised by the fact that the symptoms do not decrease over time, but are growing and expanding. Thus, in the absence of appropriate treatment nocturnal symptoms are accompanied by pain, and also during the day with increasing intensity. In the long term, tunnel syndrome has a significant negative impact on the quality and quantity of rest at night, daytime activities, work and other daily routines. If treatment is delayed, muscles, nerves, and tendons may begin to deteriorate / atrophy, which can cause loss of function in the hands and fingers. The risk of surgical intervention is much lower than the negative impact on quality of life of the consequences of tunnel syndrome.