Carpal Tunnel Syndrome

What surgical treatment options are available?

Surgery is indicated for patients with severe symptoms or with evidence of nerve damage and muscle loss, symptomatic patients with no sign of nerve or muscle damage who have failed a trial of conservative therapy, and patients whose activities of daily living are severely affected secondary to their symptoms. Most patients with moderate to severe symptoms who are surgical candidates benefit from surgical intervention. The primary goal of surgery is to decompress the median nerve by cutting and releasing the transverse carpal ligament. Following surgery, the cut transverse carpal ligament heals and gradually grows back together, leaving a larger area within the tunnel for the nerve. Essentially, surgery solves and ends the anatomical confinement within the carpal tunnel and relieves the pressure on the median nerve.

Postoperatively, patients are encouraged to use their hands early on, while avoiding strenuous or forceful maneuvers and extremes of positioning.  Depending on the pre-existing severity of disease, return of muscle strength or reduction in symptoms can vary from days to months following surgery. It is important to note that while most surgeries are successful, complete symptomatic relief may not occur, especially patients who have progressed and developed permanent nerve damage and those patients whose CTS is secondary to medical conditions associated with progressive neurologic compromise (diabetes).

The two main surgical procedures available to patients are the open carpal tunnel release and the endoscopic carpal tunnel release. In the following pages, the two procedures will be described and then compared. Each technique has risks and benefits that should be weighed and discussed with your surgeon.

What are risks of surgical repair?

Risks for either surgery include the standard risks that are associated with any procedures which include:

•Pain (during the procedure and postoperatively) and persistent wrist pain different from the original symptoms.

•Bleeding/Hematoma

•Edema/Swelling

•Wound Infection

•Nerve or tendon irritation/injury

•Scarring at incision sites

•Unsuccessful treatment of CTS or failure to completely cut and separate the transverse carpal ligament which allows persistent symptoms. This may require additional surgery or procedures.

•Complex regional pain syndrome - a rare condition of chronic long-term pain causing a burning pain in the affected extremity.

•Recurrence of CTS symptoms long after an apparently successful surgery.

 

Continue to "Open Carpal Tunnel Release"

Return to "Non-surgical Treatment Options"

 

 

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Additional Information

Please see the provided Additional Links and Resources about Carpal Tunnel Syndrome for additional information and references.