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An orthopedic surgeon,
Dr. Jonathan Cluett, said that carpal tunnel surgery could be done. It is
not only available, but also can be effective in terms of treatment.
However, carpal tunnel surgery is often not necessary until symptoms have
shown no
improvement after a long period of non-surgical treatment. It may also be
needed when persistent loss of feeling or coordination in the fingers restricts normal daily routines. Lastly,
surgery may be required when the median nerve has been damaged
as indicated in test results.
The most common procedure is the carpal tunnel surgery release. It involves
making an incision in the fibrous sheath around the carpal tunnel. By
releasing tension in the carpal tunnel, the pressure is removed from the
nerve.
In order to perform an open carpal tunnel surgery release, the surgeon makes
a four centimeter incision across the middle of the palm. The surgeon
carefully dissects the tissues down to the carpal tunnel. The carpal tunnel
is opened up to relieve the pressure on the nerve. It only takes about 15
minutes and can be performed under local, regional, or general anesthesia.
There are a lot of individuals who are afraid of the big needles for
injections or who dread the hospital. To avoid carpal tunnel
surgery, early diagnosis and treatment are important to avoid permanent
damage to the median nerve.
A physical examination of the hands, arms, shoulders, and neck can help
determine if the patient's complaints are related to daily activities or to
an underlying disorder. This can also rule out other painful conditions that
mimic carpal tunnel syndrome. The wrist is examined for tenderness,
swelling, warmth, and discoloration. Each finger should be tested for
sensation, and the muscles at the base of the hand should be examined for
strength and signs of atrophy. Routine laboratory tests and X-rays can
reveal diabetes, arthritis and fractures.
In conducting the Tinel test, the doctor taps on or presses on the median
nerve in the patient's wrist. The test is positive when tingling in the
fingers or a resultant shock-like sensation occurs. The Phalen, or
wrist-flexion, test involves having the patient hold his or her forearms
upright by pointing the fingers down and pressing the backs of the hands
together. The presence of carpal tunnel syndrome is suggested if one or more
symptoms, such as tingling or increasing numbness, is felt in the fingers
within one minute.
Often it is necessary to confirm the diagnosis by the use of
electrodiagnostic tests. In a nerve conduction study, electrodes are placed
on the hand and wrist. Small electric shocks are applied and the speed with
which nerves transmit impulses is measured.
In electromyography, a fine
needle is inserted into a muscle. Electrical activity viewed on a screen can
determine the severity of damage to the median nerve. Ultrasound imaging and
magnetic resonance imaging are also of help in determining whether the
patient needs to undergo a carpal tunnel surgery.
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