When we have patients in for carpal tunnel surgery, we like to explain the various treatments that we go through before we start surgery. Just because you are diagnosed with carpal tunnel, it doesn't mean that you necessarily need surgery immediately. We have a full course of procedures that we like to employ to start the patient down the road to recovery.
Step 1 - Recognizing and correction of mechanical issues.
The wrist is a very versatile and dexterous part of the human anatomy, offering a full range of motion that enables it to perform the various tasks that are required of it. However, this can lead to stress on the joint that, with repetitive motions and cramped positions from a job. This can cause stress on the joint, leading to inflammation and pain. The first course of action is a splint that will help keep the joint in the proper position. This can be worn at work and during sleeping hours. The brace makes sure that the wrist stays straight, and can start the healing process.
Step 2 - Steroid Injection
This is a step beyond the brace. The steroid injection is designed to reduce swelling in the joint to hopefully reduce the pain and give range of motion back to the wrist. The injection is given straight to the carpal tunnel.
Step 3 - Surgery
If these treatments fail, the next step is surgery. Pressure on the nerve is decreased by cutting the ligament that forms the roof (top) of the tunnel on the palm side of the hand (see Figure 3). Incisions for this surgery may vary, but the goal is the same: to enlarge the tunnel and decrease pressure on the nerve.
Following surgery, soreness around the incision may last for several weeks or months. The numbness and tingling may disappear quickly or slowly. It may take several months for strength in the hand and wrist to return to normal. Carpal tunnel symptoms may not completely go away after surgery, especially in severe cases.