Carpal tunnel release is the surgery used to treat and potentially heal the painful condition known as carpal tunnel syndrome. It helps by making room for the median nerve and tendons passing through the tunnel.
Previously thought of as injury caused by a repetitive motion performed by the wrist or hand, now the doctors know that carpal tunnel syndrome is most likely a congenital predisposition. As some people have smaller carpal tunnels than others, a carpal tunnel release helps improve function and eliminate pain.
Carpal tunnel syndrome can be caused by injury, sprain or fracture, or repetitive use of a vibrating tool. The median nerve passes through the carpal tunnel in your wrist. In case of pressure to the median nerve, this syndrome can be caused.
Carpal tunnel release surgery is a medical procedure used to treat and potentially alleviate the painful condition known as carpal tunnel syndrome. This syndrome is a common disorder caused by the compression of the median nerve in the wrist, leading to symptoms such as pain, numbness, and sometimes even disability of the hands.
The median nerve and tendons that allow your fingers to move pass through a narrow passageway in the wrist are called the carpal tunnel. This tunnel is formed by the wrist bones on the bottom and the transverse carpal ligament across the top (or inside) of the wrist. When the tissues within this tunnel swell due to injury or other factors, they can press on the median nerve, causing the aforementioned symptoms.
Carpal tunnel syndrome can be caused by a variety of factors. It was once believed to be caused solely by an overuse injury or repetitive motion done by the wrist or hand, often at work. However, it’s now understood that while these factors can contribute, there are other elements involved as well. These include congenital predisposition, injury such as a sprain or fracture, repetitive use of a vibrating tool, and conditions like pregnancy, diabetes, thyroid disease, and rheumatoid arthritis.
In a carpal tunnel release surgery, the surgeon cuts through the ligament that is pressing down on the carpal tunnel. This action creates more room for the median nerve and tendons to pass through the tunnel, which usually improves pain and function. The surgery can be performed as an open surgery or a minimally invasive endoscopic surgery. The choice between these two methods depends on various factors, including the complexity of the surgery, surgeon/patient preference, and the potential for complications.
Carpal tunnel release surgery is typically recommended when non-surgical interventions for carpal tunnel syndrome, such as over-the-counter pain medicines, physical therapy, changes to work equipment, wrist splints, and steroid injections, do not relieve the pain.
The cost of Carpal Tunnel Release surgery may vary based on the patient's specific surgical needs, surgeons' fees, and way of treatment and hospital fees.
With an incision on the base of the palm of the hand, the transverse carpal ligament is cut, releasing pressure on the median nerve.
Carpal tunnel surgery might be necessary when you’re experiencing persistent and severe symptoms of carpal tunnel syndrome that non-surgical treatments fail to alleviate.
Non-surgical treatments for carpal tunnel syndrome include over-the-counter pain medicines, physical therapy, changes to work equipment, wrist splints, and steroid injections in the wrist. However, if these interventions don’t relieve the pain, or if the symptoms of carpal tunnel syndrome have lasted a prolonged period with no relief, surgery might be recommended.
Another reason for considering surgery is when the muscles of the hands or wrists are weakening and actually getting smaller due to severe pinching of the median nerve. Over time, carpal tunnel syndrome can weaken the muscles of your hands and wrists3. If symptoms persist for too long, the condition can keep getting worse. In such cases, surgery might be suggested to prevent further deterioration and to restore function.
A diagnosis of carpal tunnel syndrome confirmed by an electromyography and nerve conduction test of the median nerve is another reason to consider surgery. This test helps determine the severity of the nerve damage and can guide the decision for surgery.
During the surgery, your transverse carpal ligament is cut, which will release pressure on the median nerve, relieving the symptoms of carpal tunnel syndrome. An open carpal tunnel release surgery is done under local anesthesia, but patients will go home on the same day.
Equipped hospitals, and advanced specialized centers with experienced doctors and specialists are available in all medical treatment areas in Iran. Also, good hotels and entertainment centers have made Iran an appropriate choice for patients who are dealing with carpal tunnel syndrome and need Carpal Tunnel Release surgery.
In Iran, carpal tunnel release surgery is performed using two main methods: Open Carpal Tunnel Surgery and Endoscopic Carpal Tunnel Release. Iran offers both open and endoscopic carpal tunnel release surgeries, and the choice of method depends on various factors. Both methods have been proven to be effective in treating carpal tunnel syndrome.
Open Carpal Tunnel Surgery involves making an incision in the palm of your hand. The soft tissues between the skin and the wide carpal ligament are divided, and the ligament is directly visible. The surgeon needs to see both ends of the ligament so that they can ensure that the ligament is completely free, and can protect the surrounding nerves during the surgery. This method allows the surgeon to directly view and access the carpal tunnel.
Endoscopic Carpal Tunnel Release is a less invasive procedure. In this method, the surgeon makes a small incision in the wrist area and uses a camera and specialized instruments to release the transverse carpal ligament from the inside out. This method may result in less post-operative pain and a quicker recovery.
Both types of surgeries are very effective at improving symptoms of carpal tunnel syndrome. The choice between these two methods depends on various factors, including the surgeon’s expertise, the patient’s preference, and the specific characteristics of the patient’s carpal tunnel syndrome.
The cost of carpal tunnel release surgery can vary depending on several factors, including the specific hospital and the type of surgery (open or endoscopic) performed. In Iran, the healthcare system is known for its affordability compared to many other countries, and this extends to carpal tunnel release surgery.
The cost of carpal tunnel surgery in Iran is around 800-1000 USD. This cost typically includes the surgeon’s fee, hospital charges, anesthesia, and post-operative care. However, it’s important to note that the final cost can vary depending on individual circumstances and additional medical needs.
Iran has a large number of applicants for carpal tunnel surgery, and the country’s hospitals offer comprehensive services to patients suffering from carpal tunnel syndrome. These services include a full team of orthopedic consultants, radiologists, and musculoskeletal physiotherapists.
Carpal tunnel release surgery, while generally safe and effective, does carry certain risks. As with any surgical procedure, there’s a risk of bleeding and infection. Proper care of the incision area and following the surgeon’s instructions can help minimize these risks.
One of the more common complications is known as pillar pain. This occurs on the sides of the surgical incision in the palm, where the transverse carpal ligament attaches to the carpal bones. Pillar pain can be quite troublesome and may take several months to resolve. Treatments for pillar pain may include rest, massage, and hand therapy.
Another potential risk is injury to the median nerve or nerves that branch out from it. This could lead to persistent numbness and tingling, which are symptoms of carpal tunnel syndrome. In some cases, if the carpal ligament is not completely released during surgery, it can lead to persistent compression on the median nerve and therefore, persistent symptoms. This complication is more common with endoscopic carpal tunnel surgery.
In some cases, people who have had carpal tunnel syndrome for a long time may have persistent numbness and tingling even after surgery. This is because long-standing compression to the median nerve can cause nerve damage that is so severe that sensation is never restored to normal.
Preparing for carpal tunnel release surgery involves several steps to ensure a successful procedure and recovery.
Firstly, it’s important to inform your healthcare provider about all the medicines you are currently taking, including over-the-counter medicines, vitamins, herbs, and supplements. Certain medications, such as ibuprofen, aspirin, or naproxen, may need to be stopped as they can make it harder for the blood to clot.
If you’re a smoker, it’s recommended to quit before the surgery. Smoking can delay healing and may complicate both the surgery and recovery process.
You may also need to undergo certain tests before the surgery. These could include blood tests or an electrocardiogram to assess your overall health and readiness for the procedure.
On the day of the surgery, follow any directions given by your healthcare provider for not eating or drinking before the procedure. This is usually necessary if you’re going to be given anesthesia during the surgery.
In addition to these steps, it’s also beneficial to prepare your home for your recovery period. This might include arranging for help with tasks that could strain your hand, setting up a comfortable area where you can rest and elevate your hand, and preparing meals in advance.
Remember, each individual’s health situation is unique, so these are general guidelines and may not apply to everyone. Always consult with your healthcare provider for personalized advice on preparing for carpal tunnel release surgery.
Carpal tunnel release surgery is a procedure performed to alleviate the symptoms of carpal tunnel syndrome; a condition caused by pressure on the median nerve as it passes through the wrist. The surgery is typically performed in an outpatient setting with local anesthesia or light sedation.
The procedure involves releasing the pressure on the median nerve by cutting the transverse carpal ligament. This ligament forms the top of the carpal tunnel and when it’s tight or swollen, it can compress the median nerve causing symptoms of carpal tunnel syndrome.
The surgery can be performed using two methods: open carpal tunnel release and endoscopic carpal tunnel release. In an open carpal tunnel release, a hand surgeon makes a 2 to 3-cm incision in the palm directly over the carpal tunnel and cuts the transverse carpal ligament from the outside in. This method allows the surgeon to directly view and access the carpal tunnel.
In an endoscopic carpal tunnel release, a hand surgeon makes a small (less than 1 cm) incision in the wrist area and uses a camera and specialized instruments to release the transverse carpal ligament from the inside out. This method is less invasive and may result in less post-operative pain and a quicker recovery.
Both types of surgeries are very effective at improving symptoms of carpal tunnel syndrome. The choice between these two methods depends on various factors, including the surgeon’s expertise, the patient’s preference, and the specific characteristics of the patient’s carpal tunnel syndrome.
After the ligament is cut, the pressure on the median nerve is relieved, which usually improves pain and function. Over time, the ligament heals with more space for the median nerve and tendons, preventing future compression.
Carpal tunnel release surgery is a well-established and effective treatment for carpal tunnel syndrome. It involves cutting the transverse carpal ligament to relieve pressure on the median nerve, thereby alleviating the symptoms of carpal tunnel syndrome.
After carpal tunnel release surgery, you can expect a recovery period that involves several stages.
Immediately after the surgery, you may experience some pain and swelling in the operated area. Simple painkillers such as paracetamol or anti-inflammatories such as ibuprofen should be enough for the first few days. You’ll likely have a dressing that supports and protects the incision but leaves the fingers free for movement. This dressing should be kept dry, so when bathing it is advisable to cover your dressing using a large-sized rubber glove or a plastic bag.
Hand elevation is important to prevent swelling and stiffness of the fingers. It’s safe to use the fingers for day-to-day activities such as eating, dressing, and brushing your hair. These activities all help to prevent stiffness and swelling.
Your stitches will be removed at about 10 to 14 days after the operation. Following this, patients can usually return to light hand use relatively quickly, in only 1-2 weeks. However, there may be continued pain, swelling, or sensitivity.
Some form of rehabilitation is common after carpal tunnel release surgeries. This may include physical and occupational therapy. You will also likely wear a wrist brace—a carpal tunnel brace—for a few weeks after surgery.
Numbness, coordination, and strength in the hand gradually improve over several weeks and months and may improve up to or beyond a year from the surgery. You will find that your grip is weaker than before the operation and slightly uncomfortable. This can be a bit frustrating but you should be back to full power by 6 to 12 weeks as healing occurs.
Recovery after carpal tunnel release surgery involves managing initial pain and swelling, protecting the incision, gradually returning to light hand use, engaging in rehabilitation, and experiencing gradual improvement in hand function.
