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What is Carpal Tunnel?
The carpal tunnel is a small area between a band of fibrous tissue and the wristbone. A nerve goes through this small tunnel. The nerve receives impulses from the thumb, index and middle fingers on the hand. Any type of swelling or inflammation can irritate the area, putting pressure on the nerve. This may result in pain, tingling or numbness in the hand.
The causes of carpal tunnel can be many. Repetitive motion such as typing without stopping can cause irritation and swelling in the area, putting pressure on the nerve. There are some conditions in which substances are deposited around the area of the carpal tunnel and cause swelling of the area and pressure on the nerve housed within the carpal tunnel.
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Treatment for Carpal Tunnel
The preferred treatment for carpal tunnel syndrome is rest, immobilization and ice to reduce the swelling. Life changes may be required if it is repetitive motion that stimulates the inflammation in the wrist. Other contributing conditions, such as arthritis, pregnancy, and obesity must be evaluated and treated which if effective may reduce the pain and discomfort.
Some medications can be used in the treatment of carpal tunnel including vitamin B6 and anti-inflammatory drugs. These are often attempted in an effort to reduce the swelling and inflammation.
In the event that the preferred treatment does not work, a minimally invasive surgical procedure called endoscopic carpal tunnel release may be needed. This is a simple procedure that involves cutting the fibrous band surrounding the area of the carpal tunnel and releasing the pressure on the nerve.
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Endoscopic Release Procedure
Carpal tunnel release via endoscopy is a recently developed procedure that is less invasive that the open release procedure. It involves two small incisions, one in the wrist and one in the palm through which a small endoscope is inserted. This allows direct visualization of the carpal ligament using an endoscope. Small cuts are made in the ligament to reduce the tension which can reduce the pain. As more orthopedic surgeons are introduced to the procedure and trained with the endoscope, it is likely that this will become the preferred procedure for carpal tunnel syndrome.
The surgery requires local anesthetic and can be done on an outpatient basis. The procedure takes 30-45 minutes and is done in an operating room. The benefits of using endoscopy rather than opening the wrist area with a lengthy incision is there is less trauma to the surrounding tissue and recovery time is usually much quicker.
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What to Expect Following Endoscopic Carpal Tunnel Release
Most patients wear a splint following surgery until the sutures are removed. Following this they may need to wear a splint while working. There may be pain in the wrist or palm following the surgical procedure. If so, the patient should refrain from heavy lifting.
Most people, can return to normal activities and to work within 3-6 weeks after the endoscopic release procedure.