Carpal tunnel syndrome (CTS) is a condition caused by pressure to the median nerve, generally due to inflammation to the tendons running through the carpal tunnel in the wrist. Symptoms include tingling, numbness and pain along the thumb, index, middle and half of ring fingers, particularly waking up at nights. The symptoms improve with shaking the hand. Long duration of symptoms may affect the median nerve, leading to wasting of muscles over the base of thumb (thenar eminence), muscle weakness and poor fine motor skills of the hand.
The diagnosis of CTS is confirmed on Nerve Conduction Study.
Some non-surgical treatments can relieve Carpal Tunnel Syndrome. These include avoiding activities that may cause or aggravate the condition, physiotherapy and resting the affected hand and wearing splints on the affected hand overnight. In some cases diuretic medication may reduce fluid retention and ease the pain and corticosteroid and/or local anaesthetic injections can help reduce any swelling, although this is generally only temporary.
Carpal Tunnel Surgery (also referred to as Carpal Tunnel Release or Carpal Tunnel Decompression surgery) involves a 5cm incision from the wrist along the middle of the palmar, and releasing of the transverse carpal ligament, which reduces pressure on the median nerve underneath the ligament.
This surgery is done as a day case, taking about 30 minutes. Potential complications of surgery include bleeding, infection, painful scar, stiffness of the hand and rare risks of recurrent CTS, nerve injury and chronic pain. The patient is advised to start gentle mobilisation of the affected fingers soon after surgery. The bandages are removed within 7-10 days and reviewed within 2 weeks. No suture is required to be removed. Once the wound is sufficiently healed, active mobilisation of the hand and fingers using a squeeze ball and scar massage are encouraged to reduce the risk of a stiff hand and scar pain.