Carpal Tunnel Release (Surgery)

What is Carpal Tunnel Release?

carpal tunnel release after scarsA surgeon cuts the roof of the transverse carpal ligament in the wrist. The goal is to release the pinched median nerve. Carpal Tunnel Release is one of the most common surgical procedures performed in the United States.1

What type of surgeon performs Carpal Tunnel Surgery?

Typically, an orthopedic surgeon.

How soon do I have to decide about having surgery?

This is an individual decision. Putting off the decision can make the problem more severe and increase the chances for needing surgery. Although, rushing can lead to uniformed decisions. A second opinion is always useful.

Coach Cathy was really frightened when she learned that waiting too long to address her hand problem might cause permanent nerve damage.  She was also overwhelmed by the thought of surgery.

The Carpal Tunnel Team interviewed Orthopedic Hand Surgeon, Dr. Dennis Sagini. He said,

atrophy if left untreated. Carpal tunnel release was needed here“Once the disease process is severe and you’ve lost muscle function, there’s muscles atrophy and constant numbness. Sometimes that disease process has reached a point where even with surgical management we’re not able to return someone back to their normal function”

Can I avoid surgery?

Possibly.  The best course is to address your symptoms early and completely. Dr. Sagini said,

“Usually, if something’s done sooner, the treatment can be more conservative.”

When the disease process is treated later, then surgery may be the only option.

Carpal Tunnel Coaching provides conservative self-care options. Wouldn’t you rather spend a few minutes a day taking care of yourself before laying down for a surgical procedure? Imagine if carpal tunnel release can be avoided. How much easier would that make your life? If you have had surgery already, this routine makes recovery easier. And it helps reduce your chances of re-injury.

What can you do now?

  • Follow this simple exercise routine. It goes at your own pace. It’s less than 20 minutes a day! This Coaching Program and Exercise Routine has a proven protocol for reducing the soft tissue strain in your arms while improving your posture for less than $100. For good hand less than $100 is a fraction of the money you could lose from time lost from work.  On average over 30 days a year per person is spent missing work due to carpal tunnel syndrome.

What should I know about Carpal Tunnel Release?

Open Carpal Tunnel Release and Endoscopic Carpal Tunnel Release are two common corrective surgeries. Both are outpatient surgeries using local or regional anesthesia with sedation. Unless there are complications, you will go home the same day. A splint or heavy bandage will be worn for about a week.  After the splint or heavy bandage is removed, your recovery program will focus on regaining mobility and strength.

Regardless of the way in which a carpal tunnel release is performed, studies show long-term outcomes are essentially identical.

Open Carpal Tunnel Release Surgery

The transverse carpal ligament is cut in order to enlarge the carpal tunnel. The incision (up to two inches long) enters through the palm over the carpal tunnel, through the skin, through the palmer fascia and finally through the thickened transverse carpal ligament.

Endoscopic Carpal Tunnel Release Surgery

release3A camera with a blade housing allows the surgeon to see the fibers on a monitor (similar to the one in the image). In a single-incision procedure, the incision is made across the wrist, allowing quicker recovery and less immediate post-operative discomfort.  Smaller incisions tend to lead to fewer complications such as infection and wound separation.

Complications in Carpal Tunnel Syndrome surgery are relatively uncommon.

What are the costs associated with Carpal Tunnel Syndrome surgery?

Direct Costs:* $30K – $35K
Indirect Costs:** $60K – $140K
Total Costs: $90K – $175K
Time Away From Work: 4 – 6 weeks minimum

What are the costs associated with Carpal Tunnel Syndrome WITHOUT surgery?

Direct Costs:* $8K – $12K
Indirect Costs:** $16K – $48K
Total Costs: $24K – $60K
Time Away From Work: varies

*Direct Costs include wages, hospital bills, medication, physical therapy, medical supplies, etc.

**Indirect Costs are estimated at two to four times direct costs and include lost productivity, wages for temporary workers, time to train temps, overtime, stress, etc.

How effective is surgery?

Dr. Sagini, Orthopedic Hand Surgeon, answers this question:

“I think the take home point for carpal tunnel surgery is that surgery does not necessarily work immediately or completely. When someone has a carpal tunnel release performed, the symptoms typically do not worsen and, in general, we are able to achieve symptom resolution.  But that is not always the case. It’s important to know when a Carpal Tunnel Release Surgery is performed; individuals vary very drastically in terms of their symptom resolution. Surgeons are not able to make someone 18 again in all incidences.”

According to studies, up to 90% of patients were able to return to their same jobs after carpal tunnel release.

NOTE: Surgery may not correct your pain if you have been misdiagnosed.

What are the possible complications from Carpal Tunnel Release?

  • Excessive bleeding
  • Infection
  • Injury to the median nerve or nerves that branch out from it
  • Injuries to surrounding blood vessels
  • Sensitive scar
  • Weakness
  • No relief of your initial complaint

Talk openly with your doctor before any operation. Make sure you understand what risks are involved, the severity of your specific situation. And understand all your personal options. Then get another opinion. Stay informed.

How long until I feel better?

People vary in the time it takes to heal.

Symptoms typically do not worsen and generally resolve.  This is not always the case. Symptoms may resolve relatively quickly, in days to weeks.  Some people may take five or six months before they feel better.

What factors could affect my surgery recovery time?

  • Smoking
  • Age
  • More than one Carpal Tunnel Surgery in the same wrist
  • Pre-existing health conditions
  • Recurrence of work overload
  • Post-op complications

Can I still have problems with my hands and wrists after carpal tunnel release (surgery)?

Yes, there is always this possibility. If soft tissue tightness and loss of grip strength is not addressed, your hands and wrists will still be challenged. This is where Carpal Tunnel Coaching’s video program can help you.

References

  1. National Institute of Neurological Disorders & Stroke
  2. Personal conversation with Dr. Dennis Sagini
    Fort Myers, FL
    Office Phone: 239.337.2003
  3. Endoscopic Surgery: A Review of 753 Cases in 486 Patients.
  4. New England Musculoskeletal Science Institute
  5. Rodner, Craig M.,Katarincic, Julia. (2006)
    Open Carpal_Tunnel_Release.
    Techniques in Orthopaedics ®21(1): 3–11
    Lippincott Williams & Wilkins, Inc.
  6. Endoscopic surgery: retrospective study of 390 consecutive cases.
  7. Surgical Outcome of Endoscopic Surgery in 100 Patients with Carpal Tunnel Syndrome.
  8. Hopkins Medicine
  9. Creative Commons