Endoscopic Carpal Tunnel Release Surgery

Carpal tunnel syndrome is a condition caused when the median nerve, which runs from the forearm into the hand, is compressed or squeezed as it travels through the wrist. This compression can be caused by a variety of factors, including repetitive hand and wrist movements, such as typing, using a mouse, or assembly line work, as well as certain medical conditions like diabetes, rheumatoid arthritis, and thyroid gland imbalance. In some cases, carpal tunnel syndrome may be caused by trauma to the wrist or a wrist fracture.

There are several less invasive treatments for carpal tunnel syndrome that can be tried before considering surgery. These may include wearing a wrist splint to keep the wrist in a neutral position, performing specific exercises to strengthen and stretch the hand and wrist, pain medications, ultrasound therapy, and corticosteroid injections to reduce inflammation and relieve pressure on the median nerve.

However, when these carpal tunnel treatment methods are insufficient, surgery may be required. The traditional surgical approach to treating carpal tunnel syndrome involves making a large incision in the wrist and hand to access the carpal tunnel.

But newer, less invasive endoscopic carpal tunnel release surgery is a newer surgical procedure used to treat carpal tunnel syndrome with smaller incisions, less discomfort, and shorter downtime. In this article, Macomb County specialized carpal tunnel surgeon Dr. Uzma Rehman discusses the benefits of endoscopic carpal tunnel release surgery.

How Endoscopic Carpal Tunnel Release Surgery is Performed

Endoscopic carpal tunnel release surgery involves using an endoscope, a small camera, to visualize the inside of the wrist and hand through a small incision to release the carpal tunnel ligament, which compresses the median nerve.

The endoscopic carpal tunnel release technique involves making a smaller incision, typically less than 2 cm (3/4inch). Then the surgeon inserts a small camera into the wrist to visualize the carpal tunnel. The surgeon then uses specialized instruments to cut the carpal tunnel ligament, which relieves the pressure on the median nerve.

Benefits of Endoscopic Carpal Tunnel Release Surgery

There are several benefits to a surgeon using the endoscopic carpal tunnel release technique compared to the traditional open release technique. One major benefit is that the incision is much smaller, which leads to less scarring and a faster recovery time. Patients who undergo endoscopic carpal tunnel release surgery often report less pain and a quicker return to their normal activities than those who have the traditional open release surgery.

Additionally, the endoscopic technique allows for better visualization of the carpal tunnel and surrounding structures, which can lead to more precise cutting of the ligament and less risk of damage to other structures. The endoscopic technique is also less invasive and can be performed under local anesthesia, which reduces the risk of complications associated with general anesthesia.

Patients who are good candidates for endoscopic carpal tunnel release surgery typically have moderate to severe symptoms of carpal tunnel syndrome, including numbness, tingling, weakness, and pain in the hand and wrist that have not responded to conservative treatments such as splinting, medication, and physical therapy.

Patients with a known “anatomical abnormality” that can be corrected with surgery may also be good candidates for endoscopic carpal tunnel release. A known “anatomical abnormality” refers to a structural issue in their wrist or hand that is contributing to their carpal tunnel syndrome, such as a bone or ligament that is pressing on the median nerve, or an abnormality in the shape of the wrist that is causing compression of the nerve.

Recovery After Endoscopic Carpal Tunnel Release Surgery

Recovery time following endoscopic carpal tunnel release surgery is typically much shorter than with traditional open surgery. Most patients are able to return to work and resume their normal activities within a few days to a few weeks, depending on the extent of the surgery and the individual’s healing process. However, patients should expect some pain and discomfort for the first few days following surgery and may require pain medication to manage their symptoms.

Physical therapy by our certified hand therapists is an important component of the recovery process following endoscopic carpal tunnel release surgery. Patients will be instructed to perform exercises to help improve range of motion and strength in their hand and wrist. In addition, patients will be advised to avoid heavy lifting and other activities that put excessive strain on the hand and wrist for several weeks following surgery.

Specific physical therapy modalities that can be used to improve recovery after endoscopic carpal tunnel release surgery include range of motion exercises, hot and/or cold therapy, scar massage, sensory re-education, and strengthening exercises.