Carpal Tunnel Operation

What is Carpal Tunnel Syndrome (CTS)

Carpal Tunnel Syndrome is when a nerve gets trapped at the wrist.

What are the symptoms

It may start with a ‘pins and needles’ sensation in the thumb, index, middle and part of ring finger. It is often worse at night and can wake you up. Shaking the hands may relieve the sensation but it can progress into pain. It can cause muscle weakness in the hand making you drop things.

How is it diagnosed

It is often confused with pins and needles of the trapped nerve in the neck in Spondylosis. In spondylosis the symptoms are felt more in the back of the hand whereas in Carpal tunnel it is predominantly in the front of the hand. Holding the wrist forced into a ‘curled up’ position for a minute or two will reproduce the pins and needles. You will be referred for nerve conduction studies to diagnose carpal tunnel syndrome.

What treatment options are there

Splints to hold the wrist straight at night are available to buy online and at local chemists. Injections can relieve the pain temporarily and is good enough to tide over a CTS in pregnancy. The definitive treatment is operation to release the trapped nerve.

How is the operation done?

The operation used to be done in the hospital under a general anaesthetic, but now it can now be done under local anaesthetic at the Practice. The operation takes about 30 minutes.

What is the time to recovery?

When the local anaesthetic wears off it can be uncomfortable and painkillers taken before the pain starts is a good idea. The pins and needles will usually go away overnight. The skin wound will heal in a week or two, but inside, it takes 6 weeks to heal. It will be 6 months before the scar becomes completely pain free.

Most people are able to drive and write (and do washing up!) in a week after having the stitches removed. Light work can be done in 3 weeks and manual work in 6 weeks. Heavy lifting pulling etc will cause pain at the scar for up to 6 months.

Once the pain and pins and needles have gone away, one will notice the numbness. The numbness and any weakness may take 6 to 18 months for full recovery.

What are the complications

The complication rate is very low, infection and nerve damage can occasionally happen. Rarely patients do not get the expected pain relief and very rarely a condition called regional pain syndrome may increase the pain, redness and swelling with prolonged treatment and recovery.

What are the costs?

The treatment is free on the NHS, check with your practice to see if you are eligible for Primary Care Surgery. Patients that are registered with other practices can be referred to St Luke’s Surgery for treatment.