minimally invasive carpal tunnel surgery in Raleigh

Almost everyone knows at least one person who has had carpal tunnel surgery. This is because carpal tunnel syndrome is very common and affects about 5% of the adult population. When I meet new patients, they sometimes tell me “horror stories” they have heard from their family (or the internet) about carpal tunnel surgery. “Back in the old days,” carpal tunnel surgery was much more complicated than it is today. Back then, the surgery usually was done in the hospital, required general anesthesia, and involved a large incision with many stitches. Patients were often casted afterwards, and they required physical therapy due to scar tissue, stiffness, and hand weakness. Many patients needed to take weeks or months off from work to recover. And after all that, the surgery did not always relieve the symptoms. Fortunately, carpal tunnel surgery techniques have improved over the years for the benefit of patients.

Minimally invasive carpal tunnel surgery in Raleigh

Nowadays, patients can be treated safely outside of the hospital with a very low risk of infection or complications. Smaller, less invasive incisions are used to minimize the pain and scar tissue. Most patients can have surgery with local anesthesia numbing medicine without the need for general anesthesia. Casting is no longer necessary after surgery. Patients are encouraged to move their hands and use them for light activity right away to reduce stiffness, swelling, and muscle atrophy. Physical therapy is rarely needed, as most patients can do simple home exercises to recover their hand function. Most patients are able to return to office work or light duty in a few days and manual labor in about 3 weeks or so after surgery. There is now minimally invasive carpal tunnel surgery in Raleigh.

What are the results from Carpal Tunnel Surgery?

The best news is that over 90% of patients have either complete resolution of their symptoms or significant improvement in their carpal tunnel symptoms after surgery. Many of my patients experience dramatic improvement in their symptoms on the evening after surgery! Many patients regret waiting so long, and wished that they had the surgery years ago.

What are the types of carpal tunnel surgery?

Several surgical techniques are used by hand surgeons today. These procedures include open carpal tunnel release, endoscopic release, and ultrasound-guided release. When surgeons get together for meetings to discuss patient care, we debate the pros and cons of each surgical technique. At the end of the day, every surgeon has a preferred technique they recommend to their patients. The goal of any carpal tunnel surgery is to decompress the pinched nerve by cutting a tight ligament in the palm and wrist, while avoiding complications.

I prefer to use a limited open carpal tunnel release technique for my patients. This procedure can be performed with local anesthesia only, without the need for an anesthesiologist. This is called Wide-Awake Local Anesthesia No Tourniquet (WALANT). For patients with anxiety, oral Valium for relaxation or IV sedation are available as well. This type of surgery has proven to be safe, effective, and has a very low risk of complications such as infection, scar tissue, and damage to nerves and blood vessels. Most patients take ibuprofen and tylenol for postoperative pain, and many patients do not require opioid painkillers. The hand can get wet in the shower in about 4-5 days after surgery. Patients can use a small band-aid over the incision until the sutures are removed about 10-14 days after surgery. Many patients can return to light duty work within a week from surgery.

All the doctors at Raleigh Hand to Shoulder Center are experts in the diagnosis and treatment of patients with carpal tunnel syndrome. I would trust all my partners at Raleigh Hand to take care of me or a family member for a hand and upper extremity condition.

Forget what you may have heard about carpal tunnel surgery in the past! Make an appointment with a hand surgeon to learn more about carpal tunnel surgery today. Seek relief from your hand pain, numbness, tingling, and say goodbye to all those sleepless nights.

How is Carpal Tunnel Syndrome Diagnosed?

I care for patients with carpal tunnel syndrome every day. The diagnosis is usually obvious to most experienced hand surgeons, based on patient symptoms and physical examination findings. In some cases, a nerve study/EMG is ordered to confirm the diagnosis or rule-out other neurologic conditions. However, in many cases a nerve test is not necessary if the symptoms are classic. Sometimes a steroid injection or an ultrasound examination can be used to help confirm the diagnosis.

Not all hand pain, numbness, and tingling is related to carpal tunnel syndrome. Other potential causes of symptoms include diabetic neuropathy, cervical radiculopathy or cubital tunnel syndrome at the elbow. It is important to make sure the diagnosis is correct before undergoing carpal tunnel surgery. I tell patients: carpal tunnel surgery on the hand will not fix a pinched nerve in the neck. Misdiagnosis is one reason why carpal tunnel surgery may not have helped patients in the past.

What are the treatment options besides surgery for carpal tunnel?

Many of my patients with mild to moderate carpal tunnel syndrome can improve with non-surgical treatments. Wearing a wrist brace at night is often helpful to prevent the nerve from being pinched in the wrist while sleeping. Stretching exercises and hand therapy may help some patients. Steroid injections are often very helpful to relieve symptoms in mild to moderate cases of carpal tunnel syndrome.

If the nerve compression is severe, or if non-surgical treatment has not been successful, carpal tunnel release surgery is usually recommended. Carpal tunnel surgery is the best way to prevent nerve damage in the hand. Do not wait too long: if the nerve compression is severe and has resulted in nerve damage, patients may not recover normal sensation in their hand after surgery. If a patient is not warned about this possibility, they may not be happy with their results from surgery.