Carpal Tunnel Release

The carpal tunnel is a "tunnel" in the wrist that houses nine tendons of muscles, which flex the hand, and the median nerve. In the hand, the median nerve is responsible for sensation of the thumb, index finger, middle finger, and half of the ring finger. It is also responsible for some motor function of the thumb, index, and middle fingers. The floor of the tunnel is the carpal (wrist) bones and the roof is the flexor retinaculum (a band of connective tissue). 

Carpal Tunnel Syndrome is caused by increased pressure in the carpal tunnel and subsequent compression of the median nerve. The most common complaints are pain, numbness, and tingling, especially of the thumb, index, and middle fingers. Symptoms are usually worse at night; people often find themselves waking up from sleep and having to "shake out" their hands to alleviate symptoms. Many people also have difficulty manipulating small objects or have weakness in those same fingers. Untreated, long standing carpal tunnel syndrome can lead to wasting of the muscles in the thumb. In addition, many pregnant women develop carpal tunnel syndrome as their pregnancy progresses, but symptoms usually resolve after the baby is born with no surgical intervention.

Surgery to correct carpal tunnel syndrome is called carpal tunnel release. This involves a small, vertical incision where the base of the palm meets the wrist, and cutting the band of tissue causing compression on the nerve.  This is performed as an outpatient surgery, meaning you will be able to go home that day.  You will be discharged with an Ace wrap. Following discharge please ensure that the surgical site is kept clean and dry for 48 hours.  After 48 hours you may remove the bandage and shower. While showering, you may use soap and water, but be sure to pat the incision dry.  It is important that you do not submerge your surgical incision in water (i.e. no bath tubs, swimming pools, washing dishes, etc.). After patting dry, you can place a band-aid over incision line. It is important to elevate your arm on a couple of pillows to alleviate pain and swelling. You will follow up in our office 10-14 days after surgery, for suture removal.

Typically follow up appointments are scheduled every 2 weeks following surgery so we can monitor your recovery. Your stitches will be removed 10-14 days after surgery. You should not apply direct pressure to your palm or lift anything heavier than ½ gallon of milk for 2 months. You may begin scar massage once sutures are removed. This helps to flatten incision line, and reduced tenderness. A work note can be written for a 5-10 pound weight restriction if needed.

You may resume your regular diet after surgery; however, you should start slow. It is a good idea to start with things like toast, Jell-O, crackers, and soup to see how your stomach tolerates food after anesthesia. Drink plenty of fluids such as water or Gatorade and limit your intake of sodas, coffee and other caffeinated beverages.  

We will send you home with a prescription for an antibiotic and a pain medication. It is important to take your antibiotic and pain medication with food to prevent nausea (unless you are instructed otherwise). Do not take your pain medication and antibiotic at the same time as this may upset your stomach; separate them by an hour or two. You cannot drive while taking pain medication.  

Make sure to assess tingling, numbness, pain level, range of motion, and strength during recovery and monitor improvement. 

Should you develop any of the following signs and or symptoms of possible infection, call our office immediately:

  1. Fever over 100.3
  2. Chills or night sweats
  3. Unusual swelling, redness, or warmth to your incision site
  4. Purulent drainage from incision site.

Please do not hesitate to call our office with any concerns or questions you may have.

Please remember the above instructions are only a guide.  Always listen to the instructions given by your healthcare provider and follow those if in conflict with any listed above

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