Carpal Tunnel Surgery Perth

Carpal tunnel surgery, also known as carpal tunnel release, is a minimally invasive procedure to treat Carpal Tunnel Syndrome, a condition caused by excessive pressure on the median nerve in your wrist.

What is Carpal Tunnel Syndrome?

The syndrome was first described in the mid-1800s and affects women three times more than men. According to a PubMed paper, this condition affects nearly 390 million people worldwide, primarily aged 40 to 60 years. The carpal tunnel is a small inexpansible space in your wrist through which nine tendons and the median nerve pass on their way to the hand.

This median nerve helps you feel sensations in your thumb, index and middle fingers, and thumb-side-half of your ring finger.

What are the Symptoms of Carpal Tunnel Syndrome?

A reduction in the size of this space may cause you to experience symptoms like:

• Numbness
• Tingling sensations
• Weakness
• Unbearable pain

Reductions can result from swelling of the nerve or tendons, fluid retention during pregnancy, arthritis, and injuries to the wrist. People whose jobs require repetitive hand movements, like pianists, typists, and factory workers, are at higher risk of developing carpal tunnel syndrome.

Treatment Options for Carpal Tunnel Syndrome

Although carpal tunnel release surgeries have existed since the 1930s, not all cases require surgery. Some non-surgical treatment options for carpal tunnel syndrome include:

• Using wrist splints to hold your hands.
• Resting the affected hand to reduce symptoms.
• Pain medications.
• Injection of steroids into the carpal tunnel.
• Treatment of underlying medical conditions.

Why You Need Carpal Tunnel Surgery

In some advanced cases of carpal tunnel syndrome, these remedies may not suffice. You are likely to need carpal tunnel surgery if:

• The pain is not getting any better, even with pain-relieving medications.
• Your symptoms are getting worse relatively too fast.
• An electromyography [EMG] shows a rapid progression of the syndrome.
• The condition is causing the muscles in your hands to shrink in size.
• The syndrome has lasted more than six months without relief.

What is Carpal Tunnel Surgery?

Carpal Tunnel Surgery helps relieve the pressure on the median nerve within the carpal tunnel. This release can be done using either of two types of procedures - open or endoscopic. Dr. Stewart and his team will work closely with you to develop a surgical plan and treatment options to offer you life-changing relief from your symptoms.

Open carpal tunnel release surgery

A surgeon makes a small cut on the palmar side of your wrist. Before an incision, you will be given sufficient anesthesia in your hand to numb the surgical field.

The surgeon then cuts the ligament enclosing the carpal tunnel, releasing your median nerve from the pressure causing your symptoms. The surgeon may further remove some tissues surrounding the nerve and create more space within the carpal tunnel. The area is stitched up after this and covered with a bandage.

Endoscopic carpal tunnel release surgery

The endoscopic carpal tunnel release is different, as the surgeon uses an endoscope after making two smaller cuts.

One cut is at the lower end of your palm and the other at the lower end of your wrist. The endoscope gives your surgeon a more sophisticated visualization of the carpal tunnel.

Together with other tools, the surgeon cuts through the carpal ligament to relieve the pressure on the median nerve. The endoscope is removed after relieving the pressure, and the incision is stitched and appropriately dressed. The endoscopic method is more popular nowadays because recovery is faster and better.

Benefits of Carpal Tunnel Surgery

With a success rate of more than 90%, there’s a lot you stand to gain from Carpal Tunnel Release Surgery.

• It gives you long-lasting relief.
• It reduces the need for repeated wrist injections and cumbersome remedies.
• It also reduces your need to use painkillers. Research has linked excessive consumption of painkiller medications to constipation, dizziness, drug dependence, peptic ulcer disease, etc.

Possible Risks of the Procedure

There are certain risks associated with carpal tunnel release surgery, as with any procedure. In the hands of an experienced surgeon like Dr. Stewart, most of these complications are avoidable.

• Allergy to anesthetic agents applied before surgery.
• Excessive bleeding from the incision site.
• Accidental damage to the median nerve, tendons, or blood vessels around the operation area.
• Infection of the incision site, especially if meticulous care is not given to the wound.

Seek medical attention immediately if, after the surgery, you begin to experience intense pain or symptoms of infection like fever and chills. Call your surgeon's attention if the operated area swells up or has a discharge.

Post-operative Care

After the surgery, you will have to wear a bandage or a splint to protect your hand for two weeks and more. Full recovery and absolute pain relief may take at least one month. 

• Ensure you take enough pain medications as prescribed by the doctor.
• You can apply ice compresses to your hand and around your wrist within a few hours intervals every day for at least 15 minutes.
• Avoid lifting heavy objects during your period of recovery.
• Keep your hand elevated for the first few days, as it helps to reduce swelling and pain in your wrist.
• Follow all instructions given by your doctor and ensure you adhere to your physiotherapy visits to help complete recovery.

Depending on how severe your symptoms were before the surgery, the carpal tunnel release surgery may take away all or part of your symptoms. Some people regain grip and pinch strength 2 to 3 months after surgery. However, some others take between 6 to 12 months before noticing any changes.

What Next?

Carpal Tunnel Syndrome could sometimes be debilitating. If you’re experiencing any symptoms or have been diagnosed with the condition, getting an expert opinion is the next best step for you. Dr. Nathan Stewart is a fellow of the Royal Australasian College of Surgeons [FRACS] in Plastic and Reconstructive Surgery and a Consultant Specialist Plastic Surgeon. Contact Dr. Stewart and his team today to schedule an appointment.