Your doctor recently diagnosed you with carpal tunnel syndrome. Now what?

What is carpal tunnel syndrome anyway?

Carpal tunnel syndrome is the most common compressive focal mononeuropathy, which is a fancy way of saying nerve problem, of the upper extremity. An estimated 1 to 5% of the entire population is affected by carpal tunnel syndrome and of those about 65% of patients have both hands affected, we call this bilateral carpal tunnel syndrome.

The pain is generally localized in the wrist and can radiate up and down the arm. This can feel like tingling and/or numbness in the fingertips of the thumb/index/middle and a portion of the ring finger. Night time pain and numbness episodes are very common and can negatively impact sleep.

How is carpal tunnel syndrome treated?

The most conservative treatments are typically prescribed by a family physician and can include anti-inflammatories and splinting, but often times these are not enough to control the symptoms. When patients need more intervention, they are typically referred to a hand surgeon who specializes in treating carpal tunnel syndrome.

Some patients are “lucky” in that one hand is affected more than the other, and this often guides the treatment plan. In cases where both hands are equally affected or the use of both hands is critical to a patient’s livelihood, it has been much more challenging to determine the best course of action. Recent research suggests that concurrent surgeries rather than sequential surgeries may be the best choice.

Benefits of Bilateral Carpal Tunnel Surgery

Clinicians at Duke University Medical Center performed an intensive evaluation of patients with bilateral carpal tunnel surgery and the results were impressive.

Part of their results are due in large part due to newer techniques that minimize the trauma associated with any surgery. Specific to carpal tunnel surgery, this refers to an endoscopic (think small incisions and a camera) release that is one option for relief of the constant numbness and tingling. Prior research has shown that these new techniques achieves faster recovery, results in higher patient satisfaction, improves a patient’s ability to sleep through the night faster and allows an earlier return to work by about eight days over other techniques. But these results were reported for carpal tunnel surgery performed one side at a time.

The recent Duke study was among the first to explore a large group of patients to find out exactly how long the recovery process takes when both surgeries are performed at once. The findings were published in Hand and show that on average patients were able to perform activities of daily living about five days after the operation! Daily living was defined as the ability to perform simple tasks around the home and included eating, toileting, and dressing. The authors also found that patients were able to return to work after an average of 7 days of recovery, and were able to resume full recreational activities (such as golf and tennis) after only 19 days of recovery.

This research suggests that gone are the days of prolonged carpal tunnel surgery recoveries due to invasive procedures and back-to-back surgeries.

How Can Proliance Hand, Wrist and Elbow Physicians Help?

A consultation with Proliance Hand, Wrist and Elbow Physicians can help determine if you are ready for bilateral carpal tunnel surgery and if bilateral endoscopic carpal tunnel releases are right for you. To make an appointment please contact our staff at any of our five convenient Eastside locations.

How likely am I to need my other carpal tunnel released? Answer this short questionnaire to find out more.

 



Samuel E. Galle, M.D.About the Author:

Samuel E. Galle, M.D. is a board-certified orthopedic surgeon with subspecialty fellowship training in conditions of the hand and upper extremity. He has published numerous peer-reviewed articles and surgical technique videos. He lives in Kirkland, WA with his wife, two kids and one especially spoiled Cavalier King Charles Spaniel.