The carpal tunnel is a narrow passageway in the wrist that protects the main nerve to the hand, or median nerve, which controls many of the fingers in the hand and also sends sensory signals from the hand to the brain. The carpal tunnel is composed of tendons, bones and ligaments that may become inflamed and compress the median nerve. This results in numbness, pain, weakness and tingling in the hand. If surgery in necessary, a patient has a few options to consider.
Palm Inscision
Most cases of carpal tunnel surgery are done on an outpatient basis and do not require hospital admission. The American Academy of Orthopedic Surgeons explains that a surgeon first makes an incision in the palm. This incision divides the ligament that lies on top of the carpal tunnel, called the transverse carpal ligament. The incision increases the size of the carpal tunnel and reduces pressure on the median nerve. Once the skin is closed, the divided transverse carpal ligament begins to heal and grow across the division. After healing, there is more space in the carpal tunnel for the median nerve to pass through.
Endoscopic Surgery
A patient may elect to have endoscopic carpal tunnel surgery. In this procedure, the surgeon makes a smaller skin incision and then inserts an endoscope, which is a small camera with an attached scalpel. The surgeon cuts the transverse carpal ligament from inside the carpal tunnel. This procedure may allow a patient to quickly recover because it is less invasive, although the outcomes of traditional and endoscopic procedures are the same. Whatever method a patient chooses, he should make sure his surgeon is experienced in one or the other or both.
Recovery
Following the surgeon's post-operative instructions will optimize recovery. According to the AAOS, the patient will be instructed to elevate her hand above the level of her heart and to continually move her fingers. Elevation and finger movement reduce post-operative swelling and hand stiffness. A patient can expect to experience mild to moderate pain after surgery. If she experiences excessive pain, she should immediately let her doctor know. Furthermore, a patient may be required to wear a wrist splint continuously for up to three weeks. Finally, a patient should limit activities that involve excessive hand use to allow the hand to properly heal. A patient should never hesitate to tell her doctor of abnormalities after surgery that she is experiencing.
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