Carpal Tunnel

About Carpal Tunnel

Carpal Tunnel Syndrome (CTS) is caused by pressure on the median nerve in the carpal tunnel at the wrist.

Common symptoms are pain in the hand and forearm, and tingling or numbness in the hand and fingers. The fingers may feel swollen and there may be weakness or clumsiness in the use of the hand.

Symptoms are often worse at night and may be relieved by shaking or dangling the hand out of the bed.

 

Non Surgical Treatment

CTS is usually managed by nonsurgical means initially.

This may give significant or complete relief, meaning surgery is not necessary.

Non-surgical treatments include:

  • Activity modification
  • Weight loss and exercise
  • Splint – usually at night
  • Steroid injection

If symptoms persist and non-surgical means are not effective, then surgery is usually considered.

Surgery

At surgery, the transverse carpal ligament is divided. This is the ‘roof’ of the carpal tunnel and division of it creates more space, thus relieving pressure on the median nerve and releasing the carpal tunnel.

The surgery can be performed by either open or endoscopic (keyhole) technique. Results are generally the same for both procedures six months after surgery.

Recovery is quicker with the keyhole technique because it requires smaller incisions in the skin but not every patient is appropriate for keyhole surgery.

FAQs

What causes Carpal Tunnel Syndrome?

CTS generally develops between the ages of 30 and 60 and is more common in women, with a female to male ratio of 3:1. Although there are many possible causes, the cause is unknown in most people.

There is some evidence that people who develop CTS have a smaller carpal tunnel, explaining why it may run in some families.

Other possible causes include:

  • Obesity – good predictor of developing CTS
  • Arthritis – inflammatory or osteoarthritis of surrounding joints
  • Pregnancy – usually resolves after delivery
  • Diabetes or a family history of diabetes
  • Trauma – recent or old
  • Increased activity, including sport or work
  • Other medical conditions – underactive thyroid, kidney disease

Is it important to treat Carpal Tunnel Syndrome?

If symptoms are mild, there may be no adverse outcome from no treatment. However, persistent and more significant symptoms may lead to permanent nerve damage, which can cause permanent loss of feeling and loss of function in the muscles that work the thumb.

Can I have keyhole carpal tunnel surgery?

Not every patient is appropriate for keyhole surgery. This will be assessed and discussed at your consultation.

How long is my recovery post surgery?

Surgery to release CTS can be performed under general or local anaesthetic and is performed as day surgery in hospital. The wound usually heals quickly and symptoms are often relieved within these first few weeks. However, any altered sensation can take many months to recover if it was present night and day prior to surgery.

The dressing is kept in place for 7-10 days post surgery and patients can use their hands for gentle activities in the few weeks post surgery.

Medical terms

carpal tunnel:  A relatively small space in the wrist through which 9 tendons and the median nerve pass into the hand

carpal tunnel release:  Surgery to relieve the symptoms of carpal tunnel syndrome

median nerve:  Supplies some muscles that work the thumb, and give sensation to the thumb, index, middle and ring fingers

transverse carpal ligament:  The roof of the carpal tunnel

open CTR:  The release is performed by making an incision in the palm of the hand

endoscopic CTR :  When the release if performed by ‘keyhole’ surgery. 2 small incisions are made and a camera is used to guide the surgery

Fees

For patients with private health insurance, total fees after rebates for carpal tunnel surgery usually fall in the range of $1500 to $2000.

Following your consultation, a tailored quote for your planned procedure will be provided to you.

For more information on fees and rebates please visit the fee section on the FAQ page.

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Randwick Plastic Surgery