Carpal tunnel release  Health Article

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