The Online Journal
Carpal tunnel syndrome is a common occurrence that affects the hands and wrists, and usually results when the median nerve is pressed or pinched. The median nerve is a major connecter between the hand and the brain and travels through a small channel bounded by wrist bones and ligament tissues that connect them together. Furthermore, there are nine tendons that pass through the same area, which can cause crowding to occur. When crowding occurs, possibly from any inflammation or swelling, the median nerve is then compressed or pinched causing carpal tunnel syndrome.
Some common symptoms that can occur are:
· Sensations of numbness and tingling in one or both hands
· Sharp pains radiating through the arm or shoulder
· Muscle weakness of index finger, middle finger, and thumb.
· Discomfort or aching in one or both hands
· Lack feeling in hand
· Difficulty in hand motor skills
Generally, minor occurrences of carpal tunnel syndrome can be treated mildly by using splints, cortisone injections, or anti-inflammatory medications; however, if symptoms still occur, surgery may be necessary.
If surgical treatment is necessary, an Open Carpal Tunnel Release is the most common procedure to have done. There are five basic steps to a Carpal Tunnel Release. They are as follows:
- First, a small incision is made in the palm of the hand, usually less than two inches.
- Second, another incision is made through the palmar fascia, which is a structure made visible through the first incision. An incision is made through this structure so that the compressed component, the transverse carpal ligament, is seen.
- Third, after the transverse carpal ligament is visible, it is cut with a scalpel or scissors. At this point, the median nerve is out of the way and protected.
- Fourth, the transverse carpal ligament is cut and the pressure is relieved on the median nerve.
- Lastly, the skin incision is sutured. The transverse carpal ligament will remain open and the gap that has occurred will slowly be filled by scar tissue.
Once the surgery is over, a bulky dressing is applied to the hand. This dressing needs to stay in place until the first office visit. The sutures will be removed 10-14 days after surgery, and avoid all heavy use of the hand for four weeks after surgery, avoid getting stitches wet, and expect pain and numbness to improve.
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