Wentworth-Douglass Hospital
(603) 742-5252
Decrease (-) Restore Default Increase (+) font size
Physicians
Site Search

Carpal tunnel syndrome
Carpal tunnel syndrome


Surface anatomy - normal palm
Surface anatomy - normal palm


Surface anatomy - normal wrist
Surface anatomy - normal wrist


Wrist anatomy
Wrist anatomy


Carpal tunnel repair - series
Carpal tunnel repair - series


Definition:

Carpal tunnel release is surgery to treat carpal tunnel syndrome . Carpal tunnel syndrome is pain and weakness in the hand that is caused by pressure on the median nerve in the wrist.



Description:

The median nerve and the tendons that flex (or curl) your fingers go through a passage called the carpal tunnel in your wrist. This tunnel is narrow, so any swelling can pinch the nerve and cause pain. A thick ligament (tissue) just under your skin makes up the top of this tunnel.

First, you will receive anesthesia (numbing medicine) so that you will not feel pain during surgery. You will be awake but also receive medicines to make you relax.

In carpal tunnel release, the surgeon will cut through this ligament to make more space for the nerve and tendons.

  • First your surgeon will make a small incision (cut) in the palm of your hand near your wrist.
  • Then your surgeon will cut the carpal transverse ligament to ease the pressure on the median nerve. Sometimes, tissue around the nerve is removed as well.
  • Your surgeon will then close the skin and tissue underneath with sutures (stitches).

Sometimes surgeons do this procedure using a tiny camera that is attached to a monitor. The surgeon inserts the camera into your wrist through a very small incision and looks at the monitor to see inside your wrist. This is called endoscopic surgery. The instrument used is called an endoscope.



Why the Procedure Is Performed:

Patients with symptoms of carpal tunnel syndrome usually try non-surgical treatments first. These are:

  • Anti-inflammatory medicines
  • Occupational therapy
  • Workplace changes to improve your seating and how you use equipment at work
  • Wrist splints
  • Shots of corticosteroid medicine into the carpal tunnel

If none of these treatments help, some surgeons will test the electrical activity of the median nerve with an EMG . If the test shows that the problem is carpal tunnel syndrome, carpal tunnel release surgery may be recommended.

If the muscles in the hand and wrist are getting smaller because the nerve is being pinched, surgery will usually be done right away.



Risks:

Risks of carpal tunnel release are:

  • Allergic reactions to medicines
  • Bleeding
  • Infection
  • Injury to the median nerve or nerves that branch off of it
  • Rarely, injury to another nerve or blood vessel (artery or vein)
  • Scar sensitivity


Before the Procedure:

Always tell your doctor or nurse what drugs you are taking, even drugs, supplements, or herbs you bought without a prescription.

  • You may be asked to stop taking drugs that make it harder for your blood to clot. These include aspirin, ibuprofen, (Advil, Motrin), naproxen (Naprosyn, Aleve), and other drugs.
  • Ask your doctor which drugs you should still take on the day of your surgery.
  • If you smoke, try to stop. Ask your doctor or nurse for help. Smoking can slow healing.
  • Always let your doctor know about any cold, flu, fever, herpes breakout, or other illness you may have before your surgery.
  • You will usually be asked not to drink or eat anything for 6 to 12 hours before the procedure.
  • Your doctor or nurse will tell you when to arrive at the doctor’s office.


After the Procedure:

This surgery is done on an outpatient basis. You will not need to stay in the hospital.

After the surgery, your wrist will probably be in a splint or heavy bandage for about a week. After the splint or bandage is removed, you will begin motion exercises or a physical therapy program.



Outlook (Prognosis):

Carpal tunnel release decreases pain, nerve tingling, and numbness better, and restores muscle strength. Still, most people are helped by this surgery.

The length of your recovery will depend on how long you had symptoms before surgery and how badly damaged your median nerve is. If you had symptoms for a long time, you may not be completely free of symptoms after you recover.



References:

Scholten RJ, Mink van der Molen A, Uitdehaag BM, Bouter LM, de Vet HC. Surgical treatment options for carpal tunnel syndrome. Cochrane Database Syst Rev. 2007;(4):CD003905.

Botte MJ. Controversies in carpal tunnel syndrome. Instr Course Lect. 2008;57:199-212.

Wright PE II. Carpal tunnel, ulnar tunnel, and stenosing tenosynovitis. In: Canale ST, Beatty JH, eds. Campbell's Operative Orthopaedics. 11th ed. Philadelphia, Pa: Mosby Elsevier; 2007:chap 73.




Review Date: 2/3/2009
Reviewed By: C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Dept of Orthopaedic Surgery. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
adam.com


Find What You Need

Events
Careers
Foundation
About Us
Contact
Directions
News
Social Media Agreement
Joint Notice
Web Privacy Policy
WDH Staff Portal

Centers & Services

Cancer Center
Cardiovascular Care
Joint Replacement
Women & Children's
Physician Offices
Other Services

Conditions & Treatments

Health Library

Support Services

Support Groups
Care-Van
Dental Center
Social Work
Food & Nutrition
Integrative Wellness
Spiritual Care
Concerns & Grievances
Homecare and Hospice

For Patients

Pay Your Bill Online
Pricing Estimates
Financial Assistance
Interpreter Services
Surgery Preparation
Medical Record Request
Advance Directives
Clinical Research & Trials

For Healthcare Professionals

Work and Life
Financial Well-Being
Career and Growth

The Wentworth-Douglass Health System includes:

 

Address

Wentworth-Douglass Hospital
789 Central Avenue, Dover, NH 03820
Phone: (603) 742-5252
Toll free: 1 (877) 201-7100