Carpal tunnel decompression is a surgical procedure performed to reduce or eliminate symptoms of the carpal tunnel syndrome.
Symptoms of carpal tunnel syndrome (CTS) are:
- Tingling, burning, or numbness, especially in the thumb, index or middle fingers.
- Pain or numbness that worsens with hand or finger movement or wakes you up at night.
- Hand stiffness or cramping that improves by shaking your hand.
- Weakness or clumsiness in your grip.
- Pain that moves up your arm.
The cause of carpal tunnel syndrome is not entirely clear, though it has been seen more often in women, than in men, and has been associated with certain occupations that involve repetitive motion. The risk of CTS is high in occupations involving exposure to high pressure, high force, repetitive work, and vibrating tools.
But there are several important non-occupational causes of carpal tunnel syndrome, like:
A. Local causes
- Inflammation
- Trauma: e.g. Colles’ fracture, dislocation of one of the carpal bones
- Tumors
- Anatomical anomalies like thickened transverse carpal ligament, bony abnormalities, abnormal muscle bellies, persistent median artery, etc.
B. Regional causes
- Osteoarthritis
- Rheumatoid arthritis
- Amyloidosis
- Gout
C. Systemic causes
- Diabetes
- Obesity
- Hypothyroidism
- Pregnancy
- Menopause
- Systemic lupus erythematosus
- Scleroderma
- Dermatomyositis
- Renal failure
- Long-term haemodialysis
- Acromegaly
- Multiple myeloma
- Sarcoidosis
- Leukemia
- Alcoholism
- Hemophilia
[Source: http://www.users.zetnet.co.uk/jil/ums/umj077/077(1)006.pdf]
An estimated one million adults in the United States (annually) have CTS requiring medical treatment [Source: Tanaka S, Wild DK, Seligman PJ, Behrens V, Cameron L, Putz-Anderson V. The US prevalence of self-reported carpal tunnel syndrome: 1988 National Health Interview Survey data. Am J Public Health 1994;84(11):1846-8. Various non-occupational causes of Carpal Tunnel Syndrome].
In carpal tunnel syndrome, the median nerve is affected. It runs through a tunnel called the carpal tunnel in the palm of the hand; hence the name carpal tunnel syndrome.
Carpal Tunnel Decompression – Procedure Overview
Carpal tunnel decompression can be done under general or local anesthesia. An incision is made into the patient’s palm near the crease in the middle, cutting into the roof of the carpal tunnel. Incisions may vary, but the aim is the same, to enlarge the tunnel and decrease the pressure on the nerve. After the incision is closed, the patient’s arm is bandaged and placed in a sling to reduce swelling.
After an hour or two, the patient is sent home, and 10 to 12 days later, the bandages and stitches are removed. It may take several months for the hand and wrist to regain its strength.
Preparing for Carpal Tunnel Decompression
- Let your doctor know beforehand about all the medication that you take, even if infrequent.
- You will have to stop taking food and fluids on the day of the operation. Your doctor will advise you further on this.
- Do not wear make-up, nail varnish or jewels (except for wedding ring). If the surgery is to be on your left hand, please remove your wedding ring.
- Bring a dressing gown, slippers and a book or magazine to read on the day of the surgery.
- Leave valuables at home.
Carpal Tunnel Decompression Aftercare
After the surgery, your hand and fingers may feel numb for some time. If you feel any discomfort, you will be given pain relief medication.
Precautions to be taken at home after carpal tunnel decompression:
- You will have to wear a sling for some days.
- Elevate your hand on a pillow while sitting.
- To encourage circulation, wriggle your fingers and begin gentle use of your hand.
- Keep the wound clean and dry.
- You can resume driving when you have gained sufficient control to turn the wheel in an emergency. It is best to avoid driving for at least 7 to 10 days after the surgery.
- You can return to work depending on the kind of work that you do. If it is sedentary work, you may resume work, the day after surgery, but lifting anything with the affected hand must be strictly avoided. If it is manual work, it will take 2 to 4 weeks before you can get back to work. Individuals working in hygienic conditions such as chefs, waitresses, surgeons (yes, surgeons occasionally get carpal tunnel syndrome) and dentists should wait until the wound has completely healed before getting back to work.
Risks/Complications of Carpal Tunnel Decompression
- Carpal tunnel symptoms may not completely go away after surgery in some cases.
- Damage to the median nerve.
- Damage to the tendons.
- Pain in the wrist when making a fist or leaning on the wrist.
- Scar tenderness.
- Weakness of the muscles at the base of the thumb.
- Worsening of pain and disability.
- Changes to sensation and color of the limb.
- Increased risk in obese people and smokers of wound infection, chest infection, heart and lung complications and thrombosis.
Benefits of Carpal Tunnel Decompression
The benefits of carpal tunnel decompression include relief from pain, numbness, tingling, cramps and other symptoms of carpal tunnel syndrome. Also, you will regain your normal strength and grip in your hand and will experience more comfort when working.
Alternatives to Carpal Tunnel Decompression
The alternative treatments for carpal tunnel syndrome are not known to have any significant advantages over carpal tunnel decompression. However, if your symptoms are mild, you can try wearing a wrist splint. Steroid injections into the wrist are another form of treatment. If you are pregnant and have developed carpal tunnel syndrome, surgery is usually not necessary. The symptoms subside post delivery.
Carpal Tunnel Decompression Abroad
The carpal tunnel syndrome can be debilitating and can amount to significant loss of work days. Hence, in severe cases, carpal tunnel decompression needs to be performed as soon as possible.
However, with skyrocketing costs of medical care in the U.S. and the long waiting lines in the U.K., people with carpal tunnel syndrome may not be able to avail of the surgery immediately or without impacting their finances. Such people can explore the options of medical care abroad in India, Mexico, or Costa Rica, where carpal tunnel decompression is much cheaper than that in either the U.S. or U.K.
Private tourist hospitals in India, Mexico, and Costa Rica are known for their high standards of their medical care. These hospitals are JCI accredited and have board-certified doctors working for them. Hence, quality is a guarantee along with the low cost of carpal tunnel decompression.
Related links:
Orthopedic Surgeon India
Orthopedic Surgeon Costa Rica
Orthopedic Surgeon Mexico
Submit free quote request on right for considering low carpal tunnel decompression abroad.
