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Carpal tunnel release

What is the carpal tunnel syndrome?

Carpal tunnel syndrome is a condition caused by a pinched nerve in the wrist. There is an anatomical compartment at the base of the palm, where the median nerve and 9 tendons pass into the hand. A swelling in this tunnel presses the median nerve, which pressure cause the symptoms of the syndrome.

Tunnel syndrome could also occur in the elbow (cubital tunnel syndrome), in the groin area, under the knee, or on the dorsum of the foot.

What are the causes of a tunnel syndrome?

Tunnel syndrome can be associated with any condition that exerts pressure on the nerve. This pressure usually caused by the swelling of the lining of the flexor tendons, fractures, injuries, joint dislocation, inflammation, hematoma, tumor, or a developmental anomaly.

Some diseases, like thyroid conditions, autoimmune diseases (diabetes), or rheumatoid arthritis, increase the risk of a tunnel syndrome.

A heavy, long-lasting strain could also contribute to the swelling of the tendons.

Typically pregnant or critical age women and men, and elder age rheumatic patients are affected by the syndrome.

What are the symptoms of the carpal tunnel syndrome?

Carpal tunnel syndrome is the most common type of tunnel syndromes. The tendons, running through the carpal tunnel, might swell and exert pressure on the median nerve. The median nerve provides feeling or sensation to the thumb, index finger, long finger, and half of the ring finger. At the level of the wrist, the median nerve supplies the muscles at the base of the thumb that allows it to abduct, move away from the other four fingers, as well as move out of the plane of the palm.

Numbness in the hand - carpal tunnel syndrome
Numbness in the hand - carpal tunnel syndrome

As a result, various neurological symptoms occur in the supplied areas, such as numbness, tingling, pain, weak grip, clumsiness. The numbness or tingling is usual in the thumb, index, middle and ring fingers. The symptoms are usually felt during the night, and later also during daily activities.

The wrist is usually swollen, sensitive for pressure, moving is painful, which radiates to the forearm, shoulder or neck.

If the condition remains untreated, the muscles will not receive sufficient nerve stimulation, why weakness and atrophy of the thumb muscle may occur.

Usually, the dominant hand is affected.

Electroneurogram - Medicover Hospital Hungary
Electroneurogram examination

How is carpal tunnel syndrome diagnosed?

The diagnosis of a carpal tunnel syndrome is usually set by an orthopedic specialist or a hand surgeon. The diagnosis has been set with the combination of a detailed history and physical examination in conjunction with the use of electrodiagnostic (EDX) testing for confirmation.

As carpal tunnel syndrome shows similar symptoms to disk herniation or circulatory system disorders, a special examination, electroneurogram (ENG) is recommended to confirm the diagnosis.

This examination helps to visualize directly recorded electrical activity of neurons in the central nervous system (brain, spinal cord) or the peripheral nervous system (nerves, ganglions). The nerve conduction velocity of a pressed nerve is very low, therefore ENG examination could verify the diagnosis.

What are the treatments for carpal tunnel syndrome?

Carpal tunnel syndrome is treated conservatively first, as it often relieves without surgery. The treatment might consist of splinting of the wrist, which helps to reduce the pressure on the nerve, and steroid injections to the carpal tunnel, to reduce the swelling around the nerve.

The surgical release of the carpal tunnel is the fastest and most effective treatment of the syndrome.

When is carpal tunnel release recommended?

If the conservative treatment didn’t take effect, or the decrease of the nerve conduction velocity is lower than the average, surgical intervention is recommended.

What happens during the surgery?

The surgery is always preceded by a personal consultation with the hand surgeon specialist. During the consultation, he provides detailed information about the necessary pre-operative tests, the process of the operation and its risks.

Carpal tunnel release is prepared as a one-day surgery.

After the surgical preparations, the hand is anesthetized locally. During the carpal tunnel release surgery, the pressure on the median nerve is decreased by cutting the transverse carpal tunnel ligament.

Carpal tunnel release - Medicover Hospital Hungary
Carpal tunnel release

This ligament forms the top of the tunnel, on the palm side of the hand.  The inflamed tissues around the tendons are removed at the same time, and at last, the surgeon closes the wound with a few stitches.

The surgery takes approximately 20 minutes.

What are the risks of the surgery?

Like every surgical intervention, the carpal tunnel release may have risks and complications. Very rarely the operational area may become inflamed, infected, and the adjacent anatomical structures – tendons, muscles, blood vessels, nerves, neighboring bones – may get injured. In some cases, pharmaceutical treatment may be needed, while in more severe cases, the operation might have to be repeated.

What shall I do after the surgery?

After a few hours of medical monitoring, the patient can leave our hospital. The day after the surgery, the bandage should be changed, and the removal of the stitches is due 10 days after the intervention. During these days, keep the wound away from water.

Easy physical exercises of the hand, wrist, and fingers are recommended 2 days after the surgery.

The wound may remain swollen, sensitive and painful for a few days after the surgery. Numbness and pain cease differently for every patient, usually a few days after the surgery. The full recovery, the regeneration of all functions of the hand, takes months, which can be facilitated with physiotherapy.

How much does a carpal tunnel release surgery cost?

The price of a carpal tunnel release is composed of several elements. At our hospital, the listed carpal tunnel surgery cost includes the surgery and the check-up one week after surgery.

We offer a separate consultation package for the first consultation, where the hand surgeon specialist decides if the surgery is recommended. The necessary pre-operative examinations can be taken at our hospital, which has an additional cost.

Our goal is to offer you the most reasonable carpal tunnel release price for the highest quality service and care.