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Carpal Tunnel Surgery

Carpal Tunnel Syndrome – Treatment and Surgery

 Carpal Tunnel Syndrome results in an unpleasant sensation of hand numbness which over the time becomes painful. It is associated with conditions that cause pressure on the median nerve at the wrist. Tendons and the median nerve pass through the anatomical compartment at the base of the palm, and are surrounded by the carpal bones. A ligament of connective tissue covers the bone and the tunnel itself. Carpal tunnel syndrome occurs when the tissues surrounding the tendons of the wrist put pressure on the nerve, narrowing the space for the carpal tunnel and crowding the nerve.

The development of the carpal tunnel syndrome comes from:

  • Genetic tendency, as the carpal tunnels are narrower in some people.
  • Bad hand posture
  • Hormonal changes during pregnancy
  • The disease is frequent in older people
  • Diabetes, rheumatoid arthritis, thyroid gland imbalance

Nevertheless, in most of the cases the syndrome has no single cause.

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 Common Symptoms of Carpal Tunnel Syndrome

  • Tingling, numbness and pain in the hand
  • Electric shocks in the fingers
  • Pain traveling from the arm to the shoulder

These symptoms might appear progressively without any injury suffered by the patien. They become constant during the day while using the hands, and due to the weakness daily activity becomes harder and harder

 Medical Diagnosis

To identify carpal tunnel syndrome, doctors will consider the symptoms and the medical history of the patient. The specialist will examine the hand and perform several physical tests, including:

  • Detect weakness of the muscles in the base of the thumb
  • Bending the wrists in certain position looking for numbness and tingling
  • Press and tap the median nerve
  • Testing the feeling of fingers with the patient’s eyes closed.

In order to confirm diagnosis, electrical test of the median nerve is mandatory. It is called electrophysiological test and it clarifies the best treatment available for each case.

X-rays are performed when wrist motion is limited.

 Carpal Tunnel Syndrome Treatment

At the early stages, the condition might be stopped if the activity related to the condition is modified. However if it not diagnosed early, surgery is necessary. When the diagnosis is uncertain, doctors will try simple measures, for instance:

Splinting – A brace must be worn at night to keep the wrist in neutral position, in order to prevent irritation when the wrists are curled during sleep or during daily activities which might aggravate symptoms.

Medication – used to relieve pain, for example anti-inflammatory drugs.

Activity modification – change the patterns of hand use.

Injections – steroid treatment, but symptoms usually come back.

Carpal Tunnel Surgery

If the patient does not gain relief after non-surgical treatments, based on the severity of the symptoms, surgery may be considered.

In most cases, carpal tunnel surgery is performed on an outpatient basis under local anesthesia. A cut is made in the palm and the transverse carpal ligament is divided in order to increase the size of the tunnel and to decrease the pressure on the nerve.

  • During the healing process, once the skin is closed, the ligament starts to grow across the division allowing more space for the nerve and for the tendons. Soreness and weakness are common for several months post-surgery.

To help the recovery process some instructions and will be given by the specialist:

  • Frequently elevate the hand above the heart
  • Move the fingers to reduce swelling and to prevent stiffness
  • Pain can be expected, so wearing a wrist brace is required for up to 3-4 weeks.
  • Avoid significant discomfort.

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 Carpal Tunnel Surgery Cost

In the United States, there are an estimated 500,000 carpal tunnel cases every year. The average surgery ranges between $7.000 and $9.000, without insurance deductibles. Additionally, hospital charge (operating room, equipment, sterilization, etc.) has to be paid.

Naturally, operating the carpal tunnel abroad, in countries like Spain, Lithuania and Costa Rica, the prices can go below $2.000, including related services such as

  • Consultation with the surgeon
  • Tests
  • Surgery
  • Hospitalization
  • Personal assistance
  • Transfer from/to the airport
  • Translation of documents

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