Question 1

Carpal tunnel over the years i have slowly built wrist pain that i'm assuming is carpal tunnel. i have heard from some friends about endoscopic carpal tunnel release surgery as a great way to help alleviate the symptoms. can someone help explain what this

Accepted Answer

Endoscopic carpal tunnel release is one type of therapy used to treat compression of the median nerve as it passes through the wrist into the hand.  On its way, the nerve travels through a tunnel.  The floor of the tunnel is made up by the wrist (or carpal) bones, and the roof is made up of a thick band of sinewy connective tissue.  The median nerve shares the carpal tunnel with nine tendons that transmit force generated by muscles in the forearm to make the fingers and the thumb grip.  Because the tunnel floor is hard bone, and the roof is tough sinew, swelling inside the tunnel has nowhere to expand into, and instead presses on the very sensitive median nerve.  There are a lot of things that can cause swelling inside the tunnel, one of the most common being chronic, repetitive movements.  Other factors that probably contribute to compression include genetics and diseases like diabetes.

Compression of the median nerve in the carpal tunnel causes the group of symptoms called carpal tunnel syndrome.  These symptoms include numbness or tingling of the thumb, index, and middle finger (other fingers are usually involved depending on the individual's anatomy); loss of dexterity; pain that can radiate into the wrist or arm; and weakness and muscle damage in the hand.  The symptoms often start out worse at night, and people with carpal tunnel syndrome often feel a bit better if they "shake out" their hands.

Numbness and weakness in the hand can have other causes, including compression of the median nerve elsewhere in the arm, and compression of nerves in the neck.  When you go to the doctor (preferably a neurologist with training in neuromuscular disorders), the doctor will examine your limb to help locate the problem.  The doctor should also discuss additional tests like an EMG nerve conduction study (see my health guide), or ultrasound.

There are a lot of ways to treat carpal tunnel syndrome.  These range from wrist splints and physical therapy, to injections, to surgery.  There are two kinds of surgery:  open, and endoscopic.  Endoscopic surgery uses an endoscope.  An endoscope is a camera at the end of a flexible tube that is used to look at the inside of the tunnel to guide surgical instruments.  In endoscopic carpal tunnel surgery, one or two small incisions are made at one end of the carpal tunnel (usually the wrist), or both (the wrist and the palm).  Using the endoscope, the surgeon will guide the surgical tools to cut part of the sinewy roof of the tunnel called the transverse carpal ligament, creating more room in the tunnel.  He would also look around for anything else that might be causing compression. The cutting goes on inside the tunnel and doesn't go all the way through to the surface of the skin.  At the end of the surgery, the surgeon will place a couple of stitches to close the hole (or holes) that he made.

By comparison, open carpal tunnel surgery creates an incision between 2 and 4 inches long from the palm to the wrist.  This incision cuts all the way through the roof of the tunnel, including the transverse carpal ligament and something called the palmar aponeurosis (the other sinewy stuff).  After open carpal tunnel surgery, the incision is usually closed by stitches and surgical staples.

Because endoscopic carpal tunnel surgery makes smaller incisions and disrupts less tissue, recovery is usually faster.  There are cases, however, where open carpal tunnel surgery might be preferable.

Question 2

Getting a hollow screw taking out of my wrist and carpal tunnel release on the 8th of april. what happens when they take the screw out? first time 4me

Accepted Answer

Once the hardware that is in the bone has been removed it takes 6-8 weeks for that to fill in with new bone. It is important to protect the wrist and hand during that time frame to avoid fractures from occurring.

Question 3

Had carpal tunnel release and but am still having sharp pains in hands and wrists more than 4 months later. what could i do?

Accepted Answer

Pain in patients with carpal tunnel syndrome is usually caused by another problem. Carpal tunnel syndrome is primarily numbness. You probably have another problem.

Question 4

Hand still swelling and painful after 20 weeks of carpal tunnel release surgery. also just had same surgery and wrist release paratendon on right hand?

Accepted Answer

This is not typical after a routine carpal tunnel release.   You should be feeling much better by now. A potential complication of any surgery is the development of rsd or crps (reflex sympathetic dystrophy , complex regional pain syndrome) this can be treated but you need to see your doctor.  Get it checked out.

Question 5

I had my carpal tunnel release done on my right dominant hand,  two months ago, but my hands still swells and there is pain on my wrist, arm and shoulder, my hand grip is so weak.is this part of healing?i am diabetic too.

Accepted Answer

What you’re going through sounds above and beyond what we would normally expect as the recovery process after carpal tunnel release. I think you deserve a reinvestigation by your surgeon into cause.

Question 6

How long after an open carpal tunnel release on the non dominant hand could sometime return to a job that does not require extensive use of the hand?

Accepted Answer

lots of things, such as severity of nerve damage, extent of operation, exact nature of your job, and any possibility of complication.  You should ask your doctor for precise advice.

Question 7

Can someone please recommend the best mouse to use at work with usb after r hand carpal tunnel release surgery. i'm afraid of losing my job please help!

Accepted Answer

After carpel tunnel release you should be improved.  Try a combination of track pad and mouse.  You are trying to alternate and give enough time to rest between movements.  Ask if dragon naturally speaking could be used.

Question 8

Had surgery for carpal tunnel release this morning my hand & fingers are still very numb & it hurts to straighten them & its been 8 hrs, is thi normal?

Accepted Answer

If you were numb before surgery it will take few months to improve. If you were not, contact the surgeon as local anesthetic should be gone by now.

Question 9

Is it ok to get a tattoo on my right shoulder a few days before carpal tunnel release surgery? ( having surgery on my right hand)

Accepted Answer

Getting tattoos and body piercings greatly increase the risk of hepatitis (viral infection  of the liver ) or some other infection. There has been an epidemic of infections since there has been wide spread tattooing and body piercings. The treatment is hard to tolerate and very expensive.

Question 10

What causes numb finger tips? all fingers no thumb same hand. already had carpal tunnel release.

Accepted Answer

Peripheral neuropathy can be the cause. Unlikely that carpal tunnel can cause numbness of little finger.

Wrist pain after carpal tunnel release

Carpal tunnel over the years i have slowly built wrist pain that i'm assuming is carpal tunnel. i have heard from some friends about endoscopic carpal tunnel release surgery as a great way to help alleviate the symptoms. can someone help explain what this

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Getting a hollow screw taking out of my wrist and carpal tunnel release on the 8th of april. what happens when they take the screw out? first time 4me

Had carpal tunnel release and but am still having sharp pains in hands and wrists more than 4 months later. what could i do?

Hand still swelling and painful after 20 weeks of carpal tunnel release surgery. also just had same surgery and wrist release paratendon on right hand?

I had my carpal tunnel release done on my right dominant hand, two months ago, but my hands still swells and there is pain on my wrist, arm and shoulder, my hand grip is so weak.is this part of healing?i am diabetic too.

How long after an open carpal tunnel release on the non dominant hand could sometime return to a job that does not require extensive use of the hand?

Can someone please recommend the best mouse to use at work with usb after r hand carpal tunnel release surgery. i'm afraid of losing my job please help!

Had surgery for carpal tunnel release this morning my hand & fingers are still very numb & it hurts to straighten them & its been 8 hrs, is thi normal?

Is it ok to get a tattoo on my right shoulder a few days before carpal tunnel release surgery? ( having surgery on my right hand)

What causes numb finger tips? all fingers no thumb same hand. already had carpal tunnel release.

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