Carpal tunnel syndrome: how does an operation work?
In many cases, surgery is an option for the treatment of carpal tunnel syndrome. In the past, two surgical procedures have become established: open and endoscopic carpal tunnel syndrome surgery.
- In open carpal tunnel syndrome surgery, the ligament located above the bony groove in the wrist (carpal ligament) is severed by the surgeon. Tissue that is constricting the nerve is also removed. This gives the nerve and tendons more space again. The incision during the operation runs along the longitudinal line of the palm, so it is hardly noticeable later on.
Both operations are equivalent in their results, but with endoscopic surgery it is often possible to put weight on the wrist again earlier. Open surgery is performed if, for example, the anatomy of the patient’s wrist deviates from the norm, the mobility of the wrist is restricted or the procedure is repeated (recurrent surgery).
Carpal tunnel syndrome surgery is performed by a hand or neurosurgeon under local anesthesia. It is usually performed on an outpatient basis. After the operation, the wrist is immobilized with a wrist splint for a few days.
When is an operation necessary?
- Failure of conservative carpal tunnel syndrome therapy after eight weeks
- Severe pain at night
- Persistent numbness
- Severely reduced values in the measurement of nerve conduction velocity
Further information on diagnosis, causes and symptoms can be found in the article on carpal tunnel syndrome.
How long does it take to heal?
Eleven days after the operation, the stitches are removed from the surgical scar. The length of time you are unable to work after an operation depends on the extent to which your hand is used at work. As a rule, you will not work for three weeks after an operation and will not do any sport.
If there is little strain on the wrist at work, you may be able to return to work sooner; if there is a lot of strain, it is often later. Always discuss this with your doctor.
If there is still no improvement six months after carpal tunnel syndrome therapy, make another appointment with a neurologist. It is possible to correct this persistent numbness with a second operation. However, in severe cases – especially if the operation was performed too late – the numbness may last a lifetime.
Possible complications of carpal tunnel surgery
In general, both surgical methods for carpal tunnel syndrome are considered to be very low-risk. The usual complaints associated with surgery, such as post-operative bleeding, infection or swelling, rarely occur. However, there is a risk of damage to the nerve or its branches. This can result in numbness in the fingers and the ball of the thumb.
After both surgical procedures, there is a risk of a single finger snapping or becoming very painful. In this case, the tendon sheath has been injured or pinched. This so-called snapping finger is treated by surgery under local anesthesia.
Exercises after the operation
For the time after carpal tunnel syndrome surgery, there are exercises that you can do yourself to support the healing process. Be sure to follow the surgeon’s advice after carpal tunnel syndrome surgery. Even if it hurts at first, it is important that you start doing finger exercises as soon as possible to maintain your mobility.
Carry out physiotherapy and exercises for several weeks after carpal tunnel syndrome treatment.
What else helps?
Surgery is not always necessary. It is possible to treat carpal tunnel syndrome without surgery. Preservative carpal tunnel syndrome treatment without surgery is indicated in mild to moderate cases. This means that the pain is classified by those affected as a burden, but not as completely restrictive in everyday life.
In general, conservative treatment is mostly used for young people, pregnant women and people whose carpal tunnel syndrome is caused by a treatable condition such as diabetes mellitus.
The symptoms of carpal tunnel syndrome can be alleviated by:
- Cortisone: In certain cases, it is necessary to use medication containing cortisone. These preparations are either injected into the wrist or taken in the form of tablets. When injecting, there is always a risk of injuring tendons and nerves during the injection.
If carpal tunnel syndrome is caused by excessive strain, it is essential to protect the hand in order to avoid further overuse.
Carpal tunnel syndrome: home remedies and homeopathy
Homeopathic treatments for carpal tunnel syndrome are advertised by many information sites on the Internet. However, their effectiveness in treating carpal tunnel syndrome has not been scientifically proven.
The same applies to home remedies: some people use flaxseed oil to treat carpal tunnel syndrome. The benefits of these remedies are not scientifically proven.
