Carpal Tunnel Syndrome
What is it?
Carpal tunnel syndrome occurs when the median nerve is trapped at the wrist. The majority of cases the cause of this is unknown although a few patients have arthritis, a previous injury, are pregnant or have thyroid problems.
Carpal tunnel syndrome causes pins & needles in the fingers, particularly at night,waking you from sleep. Pain may spread up the arm and some relief may be gained by shaking the hand. You may get symptoms during the day whilst driving, reading or on the phone. There may be difficulty with hand writing, doing up buttons and you may drop objects because of the loss of feeling.
What treatment is available?
In a some cases carpal tunnel syndrome may improve, particularly following pregnancy. In milder cases, a wrist splint or a cortisone injection may be helpful. The majority of cases with significant symptoms will be helped by a minor surgical procedure.
What does the operation involve?
The operation is done under local anaesthetic to "freeze" the skin at the wrist. The skin on the front of the wrist is cut and the tight band (transverse carpal ligament) trapping the nerve is divided. A tourniquet is rarely needed as any bleeding during the operation can be reduced by the use of adrenaline combined with the local anaesthetic injection used. The incision takes about 10-14 days to heal, and 6 to 8 weeks for the hand to fully recover.
Are there any risks?
These are small. Injury to the trapped nerve can occasionally occur. The wound may remain tender and swollen for several weeks following surgery. Infection is usually simple to treat with antibiotics. In a few cases, swelling, weakness, tingling or pain may persist for many months or occasionally indefinitely, particularly in elderly patients who have had symptoms for a long time.
Can it come back?
This is unlikely, although occasionally further surgery may be recommended if symptoms persist.