What is Carpal tunnel syndrome?
It is a common condition in which a median nerve is squeezed where it passes through a tunnel at the wrist.
What is the cause?
This can be from any form of arthritis affecting the wrist. In addition it can result from hormonal changes, an under-active thyroid and diabetes. Also, women are more commonly affected.
There is a higher incidence of developing the condition if your job requires using vibrating tools.
What are the symptoms?
They are pain, aching or numbness in the hand. These symptoms are worse in the thumb, index and middle fingers, all innervated by the median nerve. These symptoms are commonly worse at night and may disturb your sleep.
How is it diagnosed?
This can be diagnosed by examination of the hand and wrist including testing signs of weakness or muscle weakness around the base of the thumb.
Also nerve conduction tests and Ultrasound imaging may be conducted to confirm diagnosis.
Treatment
It is worth checking if there is any underlying medical condition such as thyroid gland causing the problem. Simple treatments such as resting splints for night or a working splint for the day, if the problem is brought on by particular activities.
A steroid injection into the carpal tunnel can be very effective
If the compression is too severe and nothing seems to be helping then simple Carpal tunnel release surgery should be considered.
Surgical options-
Carpal Tunnel Decompression
If you have been diagnosed with Carpal Tunnel Syndrome (CTS) then one option to get rid of it is surgery. Usually other, simpler, treatments will have been tried before you get to surgery: steroid injections and wearing splints at night. If those haven’t helped or have stopped working , then an operation would be the next step.
The surgery is almost always done under local anaesthetic and it takes less than 10 minutes so you will be in and out of hospital within an hour or so.
The operation simply involves removing the roof from the (carpal) tunnel, which is done through an incision about 1 inch long. Once the retinaculum (a band around the tendons) has been full divided and that there is no longer pressure on the nerve (decompressed) then the wound is closed with a few stitches (NOT dissolving ones) and a bandage is put on. This bandage leaves the fingers free to use and you can remove the bandage in 4 days. Stiches will be removed after approximately 10 days. Whilst the wound heals and prior to the stitches being removed you will need to keep the bandage dry when washing. It is best to put a large waterproof glove on and seal the top of the glove.
You can do everything else as normal and can drive immediately.
Gripping strongly and putting weight through the hand will take a few weeks to return to normal.