Rick Papandrea, MD: Carpal tunnel surgery is one of the most common surgeries done by a hand surgeon and it consists of relieving pressure off the nerve in the hand or going to the hand. So the median nerve is a nerve that comes right up through the palm and gets feeling into the thumb and the index and long finger and actually part of the ring finger. In carpal tunnel syndrome, it is when there is an increased pressure around that nerve and that pressure can cause you the pain and usually with that pain, numbness into that area of the hand so patients who are good candidates for carpal tunnel surgery are patients who we know have carpal tunnel syndrome and who have had a for a long enough that probably won’t go away on its own. Sometimes, carpal tunnel syndrome will come on after increased activity and sometimes it will come on as there are changes in somebody’s condition. Rather most common condition that it comes on in is pregnancy. So someone is pregnant and they get carpal tunnel syndrome but then it goes away after they delivery of the baby as somebody who doesn’t need carpal tunnel surgery. But for most, they comes on and is quite bothersome.
One of the hallmarks of carpal tunnel syndrome is that someone who awaken with their hands like numb or dead, though describe shaking their handout. Sometimes, the braces are enough, wearing a brace in the hand is enough to have that go away, so again that someone who doesn’t need to have a surgery. But if patients had the syndrome for a while, if they try things like braces, they’ve tried maybe change in the position of their hands and they do certain activities and is still bothersome regularly that person is usually a pretty good candidate for surgery. Usually, to make sure someone is a good candidate for surgery, we will get a nerve test to see the quality of electricity going across the wrist and if that shows a real severe carpal tunnel syndrome that usually leads us to recommend surgery more definitively.
If it is very mild and the symptoms are intermittent, sometimes we will just watch that. So again it goes back to how severe the condition is and how long it has been there and the patient has tried things to get to go away its own. Of all the things we do for carpal tunnel signs of the literature shows us about the only thing that definitively or definitely removes the carpal tunnel syndrome is to do carpal tunnel surgery. So on the right patient, it is a good option.
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