‘Carpos’ is a word from Greek which means wrist. Carpal tunnel is basically a passage way in wrist which is enclosed by a band of fibrous tissues as support to the joint. Most commonly known meaning of carpal tunnel syndrome is an unusual strain on right wrist when any kind of pressure is applied on median nerve & it hurts. There are few ways by which one can get carpal tunnel syndrome like repetitive of work & tendon inflammation or while pregnancy, patients suffering from diabetes, obesity & also at times trauma. According to reports, women are more commonly affected by carpal tunnel syndrome than men. It is mostly seen in the age group between 35 to 60 years. Tendon & nerve gliding exercises are used as primary treatment of carpal tunnel syndrome to minimize adhesions. However, carpal tunnel syndrome surgery is the best option in order to regulate venous return in nerve bundles of the wrist.
What is Carpal Tunnel Syndrome Surgery?
Carpal tunnel syndrome generally occurs due to excessive use of hands & exposure to repeated trauma that can result in tingling, weakness or pain in thumb, fingers, hand & sometimes in arm. Carpal tunnel syndrome surgery is a surgical process by which band of tissue around wrist are cut apart to decrease pressure on median nerve in order to relieve patients from serious pain. Carpal tunnel syndrome surgery can be performed if symptoms are extreme or when other conservative treatments have not worked for patients.
Severe pressure on nerves can happen due to various reasons including the following.
Scenarios enumerated above can cause swelling in tunnel or narrow carpal tunnel. Diabetes, thyroid conditions & rheumatoid arthritis can also be associated with this condition. Ultimately, there can be various other causes of carpal tunnel syndrome in patients.
Following list contains possible signs & symptoms of carpal tunnel syndrome.
- Family history of carpal tunnel syndrome
- Fluid build-up during pregnancy
- Swelling of lining of flexor tendons called tenosynovitis
- Dislocations of joint
- Over-activity of pituitary gland
Tingling or numbness is most often observed in thumb, middle, index & ring fingers. These symptoms are generally noticed during night but may also be felt during daily activities such as reading a newspaper or driving. In worse cases, strength & sensation may be permanently lost.
Early diagnosis & treatment are necessary to cease permanent destruction of median nerve. Physical evaluation of arms, hands, shoulders & neck areas can help decide if patient’s complaints are related to normal daily activities or to an underlying problem & also be able to rule out other painful conditions that imitate carpal tunnel syndrome. Wrist is also evaluated thoroughly for swelling, tenderness, warmth & discoloration. All fingers should be carefully tested for sensation & muscles at the base of hand should be inspected for strength & signs of deterioration. Several laboratory tests & X-rays can disclose arthritis, diabetes & fractures. Orthopedic surgeons can use several tests to try to check for symptoms of carpal tunnel syndrome.
- Tendency to drop things
- Weak grip
- Occasional clumsiness
Apart from this, an x-ray may also be taken to check for a fracture or arthritis conditions. Electrodiagnostic studies are also a possibility & which can be used to carry out diagnosis & for inspecting other nerve issues.
- Tinel's Test – During tinel's test, doctors press or tap on median nerve in patient’s wrist. This test is positive when tingling in fingers occurs.
- Wrist-Flexion or Phalen Test – This test involves having patients hold their forearm upright by pointing fingers down & pressing backside of hands simultaneously. Carpal tunnel syndrome is confirmed if one or more symptoms such as increasing numbness or tingling is experienced in fingers within a minute.
Techniques of Performing Carpal Tunnel Syndrome Surgery
There are mainly two techniques to perform carpal tunnel syndrome surgery. Orthopedic surgeons may perform carpal tunnel syndrome surgery by any of these methods depending upon the medical status of patients.
- Open Carpal Tunnel Syndrome Surgery
- Endoscopic Carpal Tunnel Syndrome Surgery
Both these are effective techniques & are elaborated as follows.
Orthopedic surgeons create a small cut near lower section of palm, near wrist of patients. Surgeons then detach the carpal ligament, which minimizes pressure on median nerve of patients. Depending upon patient’s condition, surgeons may also expel tissue from around the nerve. At the end, surgeons apply some stitches to close the wound & then cover the whole area with a bandage.
Surgeons make a cut near the lower section of wrist. After that, they insert an endoscope into the wrist of the patient. This endoscope is a flexible, long tube with an attached camera. Camera captures videos from inner side of wrist & these captured images appear on a monitoring device inside the operating room. Orthopedic surgeons will also insert other tools through this narrow opening & cut off the carpal ligament in order to relieve pressure on patient’s nerve. After performing this, surgeons then remove the endoscope & tools & subsequently close the incision with a stitch. Endoscopic carpal tunnel procedure takes around an hour to complete. Patients will receive anesthesia before undergoing this procedure. Anesthesia can prevent pain during surgery. However, patients can still experience some discomfort when anesthesia wears off. Doctors may also prescribe medications to dull severe pain.
Carpal tunnel syndrome surgery can be stressful for the patient. This information will help patients understand what they can expect & it will therefore help them safely prepare for surgery.
Patients who want to undergo carpal tunnel syndrome surgery should use the list of questions mentioned below as a guide during their initial pre-surgery consultation.
- Patients should understand exact procedure along with its benefits & risks.
- Patients should tell their doctors about medications & health products they take in order to reduce risk of bleeding during surgery.
- In case patients are taking any blood thinners, such as warfarin or aspirin, they should talk to their doctors regarding this.
Patients will get to understand a lot of things related to carpal tunnel surgery syndrome by asking these questions to orthopedic surgeons.
Carpal tunnel syndrome surgery is recommended when other treatments have failed to relieve signs & symptoms. This operation is performed as an outpatient procedure, which means patients will not need to stay at the hospital overnight. During carpal tunnel syndrome surgery, the roof of carpal tunnel is dissected to cut down tension on the median nerve. Local anesthesia is generally used to numb hand & wrist of patients, but they will remain awake throughout the procedure. This surgery can be done as open surgery, which involves making just a single cut in wrist. Some orthopedic surgeons may use keyhole surgery, where special tools, instruments & a thin long tube with a light at one end & an eyepiece at another are infused through small cuts made for the purpose in patient’s wrist & sometimes in palm. This procedure allows orthopedic surgeons to clearly see carpal ligament on a monitor during the entire operation. In this way, carpal tunnel syndrome surgery is performed by surgeons to relieve patients from persisting pain.
Orthopedic surgeons will give different recommendations for post-operative care. Most important instruction following carpal tunnel syndrome surgery is to keep hand within bandage for a few days & patients may also be advised to use a sling. Patients should keep their hand raised for at least 48 hours so as to aid in reducing any stiffness & swelling in fingers. Patients should gently exercise their delicate fingers, elbow & shoulder to prevent occurring of any stiffness. Patients may also be able to begin gentle movements on the day of their operation. After completion of carpal tunnel syndrome surgery, patients can use the hand to do light activities that will not cause further discomfort or excessive pain. Patients should refrain from using their hand for more demanding exercises or activities until it has recovered completely & which may take a couple of weeks’ time. Healing time for open release surgery is normally longer than healing time for keyhole surgery. However, both these techniques have proven to be equally effective in patients of different age groups.
There are a number of factors which may affect the decision of patients to undergo carpal tunnel syndrome surgery, including the following. In majority of cases, carpal tunnel syndrome surgery provides a healthy & permanent cure. However, it has certain risks & complications as well & which include the following.
- Are you a certified orthopedic surgeon?
- How much experience do you have in performing carpal tunnel syndrome surgery?
- Do I need to undergo carpal tunnel syndrome surgery?
- How will you perform my carpal tunnel syndrome surgery?
- Do you have any hospital privileges to perform carpal tunnel syndrome surgery?
- Are there any risks & complications associated with carpal tunnel syndrome surgery?
- What will be the cost of my carpal tunnel syndrome surgery?
- How much time will it take for me to recover following carpal tunnel syndrome surgery?
These complications can, however, be minimized by taking proper care.
Patients will recover completely after a few months following carpal tunnel syndrome surgery. On an average, patients with carpal tunnel syndrome will experience no symptoms like numbness, tingling & unbearable pain. Scars will also vanish over time & patients will get great relief from previous strain on median nerve.
- Severe infection
- Failure to completely separate roof of carpal tunnel during surgery resulting in persistent signs & symptoms
- Heavy bleeding after operation
- Serious nerve injury
- Constant wrist pain
Medical Tourism in India for Carpal Tunnel Syndrome Surgery
In recent times, obtaining best healthcare services has been added to a grand list of reasons for international patients visiting India. India now has a leveraged status in medical tourism industry due to several vital factors. Following are three main aspects that make India a good choice for orthopedic surgeries like carpal tunnel syndrome surgery.
- Top quality of orthopedic surgeries are available at unbelievably low costs
- Highly skilled orthopedic surgeons & top-class hospitals
- Most advanced medical equipment which results in clear diagnosis & faster delivery of treatments
Travcure Medical Tourism is acknowledged as one of the best medical tourism facilitators in India for orthopedic surgeries. Travcure provides best & affordable options for overseas patients to undergo complicated orthopedic surgeries like carpal tunnel syndrome surgery. Travcure has plenty to offer to global patients when it comes to a relaxed & hassle-free healthcare journey to India. Travcure delivers additional packages to international patients meant to rejuvenate their minds & enjoy the angelic beauty of the country while recovering in a most relaxing manner.