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Carpal Tunnel Surgery

What is carpal tunnel surgery?

The carpal tunnel surgery is performed in patients diagnosed with carpal tunnel syndrome. This is actually a neuropathy in which the median nerve is compressed at the level of the wrist, causing a wide range of symptoms, including paresthesia, pain and numbness. The carpal tunnel surgery is performed in order to release the nerve from entrapment, eliminating the symptoms commonly associated with the condition. The patient will have to undergo physical therapy after the procedure, so as to promote faster healing in the area and have a normal range of mobility.

The carpal tunnel syndrome appears in people who suffer from a wide range of medical conditions and especially in those who work a lot of on computers. The procedure can be performed in an open manner or endoscopic and it guarantees promising results, as the pressure on the median nerve is released. The surgery is recommended in case of aggravated symptoms (constant numbness, weakness and atrophy of the muscles in the area) and also when other solutions have failed to provide the desired results (such as night splinting for example).

What to expect after carpal tunnel surgery?

carpal tunnel surgery

Carpal tunnel surgery

After the carpal tunnel surgery, your hand will be bandaged and you will have to undergo removal of the stitches after a period of two weeks. The symptoms commonly associated with the carpal tunnel syndrome will disappear gradually. However, if you undergo physical therapy, the exercises that the physical therapist will teach you are also going to help with the symptoms. The recommendation will be that you avoid heavy work involving the hands for at least three months after the carpal tunnel surgery. The endoscopic surgery guarantees a faster recovery, because there are no large cuts made to the hand.

This is a procedure that allows you to go home in the same day. Prescription pain medication will be recommended to deal with the pain, inflammation and other upsetting symptoms. Open carpal tunnel surgery will require that you wear a protective splint for a few days, in order to protect the recently operated area. Wrist braces might also be recommended for at least two weeks after the surgery. The doctor will make the exact recommendation when you can start to use the hand again but, once again, heavy activities should be avoided for a while. Also, it is important to understand that the expectations should be different if the surgery took place on your non-dominant or dominant hand.

Procedure

There are two main methods used for the carpal tunnel surgery:

Open carpal tunnel surgery

  • The transverse carpal ligament is cut and the pressure on the median nerve is released
  • The doctor will make an incision at the base of the palm, making the transverse carpal ligament visible. After the ligament is cut, the incision is closed with stitches. Scar tissue will form at the site of the cut and this is why physical therapy is so important. The hand will be bandaged and a splint or brace might be recommended.

Endoscopic carpal tunnel surgery

  • A small incision is going to be made at the level of the wrist and/or palm, depending on the approach technique
  • The endoscope will be introduced in order to visualize the transverse carpal ligament. This will be cut with tiny yet precise instruments. The recovery period for this type of procedure is better, as there are no large incisions made in the skin. The small incision is stitched as well.

Cost

The cost of the carpal tunnel surgery depends from one clinic to the other and from one geographic area to the other. Generally speaking, the cost is around $1.300 for the actual outpatient procedure but you will also have to pay somewhere around $900 for the physician services and $500 for the anesthesia. It is for the best to check your insurance and see which costs are covered for this type of procedure. Depending on your type of insurance, you might be covered for the whole thing.

Also, it is important to understand that the cost of open carpal tunnel surgery is less expensive than the one of the endoscopic carpal tunnel surgery, because of the differences in the technology being used. If there are complications during the surgery, then the overall cost might increase dramatically. As it was already mentioned, the costs for this kind of procedure are split into three categories: first, the services of the surgeon, second the ones of the clinic or hospital and third, the ones for anesthesia. Plus, you will have to take into consideration the costs for the physical therapy recommended after the actual surgery.

Complications

These are the most common complications of carpal tunnel surgery (low rate):

  • Infection – there are few chances of infection occurring but when it happens oral antibiotics might be recommended and a second surgery will be scheduled as well in order to clean the infected area.
  • Symptoms of the carpal tunnel syndrome persist (surgical failure to release the pressure on the median nerve) – this happens because the cut of the transverse carpal ligament was incomplete or because there was a lot of fibrous tissue in that area. Sometimes, the surgery fails because there was too much damage already done to the nerve or the nerve was compressed in other areas of the body (elbow for example). The median nerve also might suffer from different diseases and the patient will exhibit the same symptoms as if it was compressed.
  • Symptoms of the carpal tunnel syndrome disappear and recur after a short period of time – revision surgery might be recommended in such cases. Recurrent symptoms might also appear when there is too much scar tissue at the site of the surgery, plus there is always the possibility that the transverse carpal ligament applies pressure on the nerve again.
  • Damage to the nerve – if that happens, the patient will experience abnormal sensations or loss of sensation, not to mention the entire functionality of the hand will be affected.
  • Persistent numbness in the area
  • Loss of mobility because of the excessive scar tissue

Pictures

Collection of pictures of carpal tunnel surgery…

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carpal tunnel surgery pictures

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Recovery time

The recovery time depends on the type of surgery that was performed:

Open carpal tunnel surgery

  • Surgery performed on the non-dominant hand – the patient can return to his or her normal activities within one or two days. However, the recommendation is that the patient waits at least two weeks before resuming normal activities, so as to allow for the area to heal.
  • Surgery performed on the dominant hand – the patient is expected to make a full recovery in a period of at least six weeks until twelve weeks. Only then, he or she will be able to resume his or her normal work-related and household-related activities.

Endoscopic carpal tunnel surgery

  • Surgery performed on the non-dominant hand – the patient can return to his or her normal activities within one or two days. However, heavy activities performed with the hands should be avoided for a period of time.
  • Surgery performed on the dominant hand – the patient is expected to make a full recovery is a period of four weeks. Depending on the patient, the recovery time might last more but physical therapy is recommended for faster healing.

Video

Watch this Carpal Tunnel Surgery Video to learn more about this condition:


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