Recently, hand injuries due to excess typing, texting, lifting heavy weights and incorrect sleeping postures have increased. One such hand injury is Carpal tunnel syndrome. When it becomes severe, carpal tunnel surgery is one of the most common hand surgeries that treat the condition. Our wrist anatomy comprises of the carpal bones on three sides, which has transverse ligament right on top.


What is carpal tunnel syndrome?


In this hand injury, the median nerve that runs across the carpal tunnel of the wrist gets squashed. It results in pain and limits some hand movements. Surgical treatment comprises of cutting away of the fibrous band inside the wrist, which is called the flexor retinaculum. It minimizes the pressure on the median nerve. In carpal tunnel syndrome, the thumb and other parts of the wrist and hand are severely affected.


Patients can sometimes notice a swelling of the wrist tendons that puts pressure on their median nerve. The swollen tissue is synovium that in a way keeps the muscles fuelled so that our fingers can move freely.  


There are several reasons why carpal tunnel syndrome can take place. It could occur from a small wrist that can be hereditary. That aside, medical conditions like thyroid issues, rheumatoid arthritis, and joint arthritis can also result in carpal tunnel syndrome.


The symptoms of this ailment are:


  • Severe hand pain
  • Needles and pins feeling in the hand
  • The thumb becomes weak
  • Experiencing shock-like pain in your fingers and thumb, that goes up to the arm


When the symptoms become severe, then the only treatment is a surgery done under an expert hand surgeon. Dr Looi Kok Poh and other specialist hand surgeons have been successfully treating hand ailments like this.  


The types of surgery available


Today, there are two primary kinds of carpal tunnel surgery available – Open surgery and endoscopic surgery. In both these surgeries, the hand surgeon cuts the ligament close to the carpal tunnel to release the pressure over the median nerve. It releases the pain gradually.


  • Open surgery: An expert hand surgeon makes an incision inside the patient's wrist. After this, he /she cut across the flexor retinaculum.
  • Endoscopic surgery: In this surgery, the surgeon makes an incision on both the patient's wrist and palm. They place in a little camera called the endoscope via one of the incisions to see the entire process. They also direct an instrument via the second cut. After that, the surgeon cuts across the flexor retinaculum.


Since the incisions are smaller with endoscopic surgery, patients might heal quickly. The pain too disappears fast. However, it’s always best to check with an expert hand surgeon to decide on the surgery type.


A carpal tunnel hand surgery is the last treatment option when the symptoms keep repeating. The conventional treatments include corticosteroid injections or wearing hand splints. Acute carpal tunnel syndrome might cause localized pain. And to heal completely from this pain and discomfort, surgery is the only solution. After the surgery, the patient can move his/her hand like before. The operation takes a day, and the patient has to be in the hospital for two days of rest. Complete recovery can happen after a month or two.  


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