Carpal Tunnel Syndrome

The carpal tunnel syndrome is the compression of the median nerve caused by swelling in a patient’s carpal tunnel (the narrow gap found inside the wrist). Consequently, the patient may begin to feel weakness, numbness or a tingling sensation on the wrist, especially near the thumb.

The resultant swelling, which slows the transmission of nerve signals, could result from underlying medical conditions that lead to poor blood flow in the tunnel or may be hereditary. These include diabetes, high blood pressure, rheumatic diseases, fluid retention in pregnancy or menopause, or an injury to the wrist.

Besides, some lifestyle habits like smoking, a sedentary life, obesity, and high sodium intake could increase the chances of getting carpal tunnel syndrome. Additionally, subjecting the wrist to excessive repeated activity may aggravate the situation and further advance the swelling. According to patients who come for treatment at our plastic surgery clinic, the symptoms usually worsen at night.

Diagnosis and Treatment

When patients walk into our plastic surgery clinic, London, for carpal tunnel syndrome treatment, our doctors will first perform physical examinations for any swellings on the wrist. Some more scans may also be carried out to confirm if there is any pressure on the median nerve. The patient’s medical and family history will also be considered for a more accurate diagnosis.

After preliminary tests, the doctor will first prescribe rest or therapeutic treatments for the arm to give it time to recover. For insurance, as a patient, you may be directed to wear a brace or splint to maintain the wrist in a neutral position to restrict movement. Non-steroidal anti-inflammatory drugs, corticosteroid injections, or a break from manual activities that call for the overuse of the wrist may also be prescribed. Finally, if the symptoms persist, the doctor may recommend carpal tunnel release surgery.

Carpal Tunnel Release Surgery

Carpal tunnel release can be carried out through open surgery or an endoscopic procedure at our plastic surgery clinic, UK. Our specialized surgeon will pick one of the two techniques depending on what was agreed with the patient during consultation. Both procedures will be done under local anaesthesia.

In the open carpal tunnel release, an incision is made between the wrist and palm the transverse metacarpal ligament is cut (or released). The open procedure can be instrumental in avoiding any risks related to nerve damage or additional wrist problems like a cyst in the wrist.

As for the endoscopic surgery, the ligament is accessed via a small hole, and an endoscope containing a nano camera and some surgical tools will be inserted. Cutting the ligament relieves the pressure build-up on the median nerve and lessens or gets rid of the pain altogether.

Sutures will be used to close the surgical site in either case, and the wound is dressed in bandages. Then, after about a week, the patient will have to return to our plastic surgery UK clinic to have the stitches removed.

Recovery from Carpal Tunnel Release

After the carpal tunnel release surgery, you may have to go through some physiotherapy to restore full pain-free mobility in the wrist. Our veteran surgeons will also ask you to avoid any activities that overextend the wrist to prevent a recurrence.

Regular use of the hand will depend on your activity level, although you could gradually work towards it as the hand heals. That’s because the ligament will repair itself over time, and in healthy circumstances, the nerve will no longer be at risk of being compressed.

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