Carpal tunnel release surgery is the only definitive way to treat carpal tunnel syndrome. Your physician may recommend you for surgery if your symptoms have not improved with conservative treatment, or have continued to worsen. While surgery cannot reverse any nerve damage that has already occurred, it can prevent further nerve damage.
What Are My Surgery Options?
Carpal tunnel surgery is the most effective way to cure carpal tunnel syndrome. This is because it’s the only treatment option that allows the nerves to fully decompress, enabling fibers to reoxygenate properly.
Open surgery and Endoscopic release surgery have both proven successful in curing carpal tunnel and alleviating pressure on the median nerve. Your surgeon should discuss the risks and benefits of each procedure with you, in order to make the decision that best suits your needs and will allow you the best possible recovery.
Open Surgery
Open surgery is the original method and is still widely used in hospitals. The procedure is more invasive because the surgeon will open up the entire hand. Following open surgery, patients will have a longer recovery time and are more likely to require occupational therapy to regain hand strength. There will also be a larger scar, which can lead to hypersensitivity, than with the endoscopic method.
Endoscopic Release Surgery
Endoscopic release surgery is performed as an outpatient procedure under local anesthesia. The technique is newer and less invasive as it uses a tiny incision and avoids cutting the palm open to expose the ligament. The surgery is performed using a miniaturized camera for direct visualization and added precision. Both hands can also be operated on at the same time (if they are both affected) unlike with the traditional open surgery method.
Recovery Milestones
Barring unforeseen surgery complications, the general timeline for recovery after carpal tunnel surgery is as follows:
Symptom Relief
Symptoms such as numbness and tingling should disappear immediately after surgery. Sleeping should also improve significantly. Swelling, stiffness, and general discomfort are common post-op. Your physician may prescribe pain medications or recommend the use of OTC pain-relievers.
Return to Activities
Gradually resuming activities is recommended as well to help improve strength. Desk jobs, light lifting, driving, etc. are all activities which you may be able to resume with the approval of your surgeon.
Although the effectiveness of the two methods is comparable and both have very low complication and recurrence rates, endoscopic delivery offers significant convenience and productivity benefits.
Due to its less invasive nature, it allows symptom relief, motor recovery and a return to routine activities much faster. The average duration of sick leave is 14 days for patients treated by the endoscopic method compared to 32 days for patients operated on “open” (Travers, 2005). The average time before resuming driving is 3 days after endoscopic decompression compared to 28 days with conventional intervention (Travers, 2005). In addition, scar pain and abutment pain are considerably reduced by the endoscopic technique, which limits the inconvenience associated with taking pain medications.
Endoscopic carpal tunnel surgery is performed frequently in most Western countries and constitutes an important advance in the treatment of this common pathology, allowing an early return to normal life. Endoscopic release is Dr. Brutus’ preferred method.
Post-Op Do’s and Don’ts
In order to aid in your healing process post carpal tunnel surgery, there are certain do’s and don’ts you should follow:
Do
- -Follow all post-op instructions provided by your surgeon
- -Change your bandage regularly
- -Rest as needed
- -Sleep with a wrist splint (as advised)
- -Strengthening exercises
- -See your doctor for follow-ups if needed
Don’t
- -Get your bandage wet
- -Showers should be done with a covering on the wrist to keep the bandage dry
- -Try to lift any heavy objects
- -Drive until cleared to do so
- -Take more than your prescribed pain medications
- -Resume normal daily activity until your doctor clears you to do so
Will I Need Occupational Therapy?
Occupational therapy can be recommended, however it is rarely needed after endoscopic release. Your therapist may suggest daily stretches and exercises, as well as ways to alter your lifestyle to properly use your wrist without strain. Therapy will begin focusing on expanding your range of motion, and build from there.
Final Thoughts
Carpal tunnel surgery is a generally straightforward procedure and recovery process. Your doctor will discuss all possible complications beforehand and answer any questions you may have. Be sure to ask any questions you may have in order to make the process easier and less stressful.
