Carpal Tunnel Syndrome and Release Surgery in Surat

The carpal tunnel is a narrow passage on the palm side of the wrist, bounded by the wrist bones and a tight band of tissue called the transverse carpal ligament. The median nerve runs through it together with the tendons that bend the fingers. When pressure inside the tunnel rises, the nerve is squeezed, and the hand starts to tingle, go numb or lose strength.

Typical features are:

• numbness or tingling in the thumb, index finger, middle finger and the thumb side of the ring finger
• symptoms that wake you at night and ease when you shake or rub the hand
• numbness while driving, holding a phone or reading a newspaper
• clumsiness with buttons, or dropping cups and tools
• in longer-standing cases, a weak pinch and thinning of the muscle at the base of the thumb

The little finger is usually spared, which helps tell it apart from other nerve problems. In many people no single cause is found. The condition is seen more often with pregnancy, diabetes, an underactive thyroid, rheumatoid arthritis, an old wrist fracture and, in some people, work that needs repeated or forceful wrist movement.

In early or mild cases, and in many pregnancy-related cases, symptoms can settle without an operation. The options include:

• a night splint that keeps the wrist straight, worn for several weeks
• changing hand positions and breaking up repetitive tasks
• treating a linked condition, such as improving blood sugar control or correcting a thyroid problem
• nerve-gliding and hand exercises, taught by a physiotherapist
• in selected patients, a steroid injection into the carpal tunnel, which may give only temporary relief; small risks include soreness and, rarely, nerve or tendon injury, and in people with diabetes it can raise blood sugar for a few days

If symptoms continue despite these measures, or the nerve shows signs of damage, surgery is discussed.

Typical recovery:

• the fingers are moved from the first day, to prevent stiffness
• a dressing stays on and the stitches are usually removed at about two weeks
• light everyday use returns within days to a few weeks, while heavy gripping and lifting wait longer
• night tingling often eases early; numbness can take weeks to months to improve, and long-standing severe numbness may not recover fully
• tenderness around the scar in the palm is common for a while

Risks in general terms are infection, bleeding, a tender scar, stiffness, incomplete relief and return of symptoms. Injury to the nerve or its branches, or to a tendon, is uncommon, and a long-lasting pain syndrome of the hand is rare.