Carpal tunnel syndrome surgery

The median nerve enters the hand through a canal in the wrist area. This canal is closed at the front by an important ligament, which is formed by a bony gutter. The median nerve and flexor tendons enter this canal, and it's when this nerve is compressed (usually by the ligament) that carpal tunnel syndrome develops.

People with carpal tunnel syndrome experience burning and tingling sensations. In addition, the extreme edge of their fourth finger as well as their thumb, index and middle fingers (first three fingers) are numb. These discomforts generally occur upon awakening or at night. Pain in the hand, shoulder, elbow and forearm can also occur. If left untreated, the disease may develop into amyotrophy of the thumb (reduced muscle volume), with reduced mobility, but also loss of sensitivity and slight clumsiness.

Before treating carpal tunnel syndrome, doctors take the time to perform several tests, including an electromyogram, which records the electrical current carried by the nerve. In this way, specialists can determine the site of compression and the degree to which the nerve is affected. The fourth and fifth fingers can also be affected (ulnar nerve).

If the nerve is left untreated, you can expect to be unable to make precise movements, such as picking up a leaf, and to lose sensitivity in the fingertips (dropping objects, for example).

If the prescribed treatment (splinting, infiltrations, creams, etc.) doesn't work, and the nerve is too badly damaged, surgery is considered. Surgery simply involves incising the carpal tunnel and cutting the anterior ligament, either under endoscopy or by opening the palm of the hand. In both cases, the operation is usually performed under local anaesthetic, with sedation if necessary.

Once the surgery has been completed, the patient can be discharged after just a few hours if all has gone well. However, hospitalization should be considered (geographical location, family situation, state of health, etc.). Healing takes place with a few dressings and lasts around two weeks, sometimes including physiotherapy sessions.

Depending on the type of activity, these can be resumed after 15 to 21 days' rest. In any case, hands can be put under water after a week, as can driving. Of course, you'll need to wait a few days for the numbness, pain and other symptoms to disappear.

It's important to be aware that secondary complications (nerve damage, swollen hand, post-operative infection...) can sometimes arise from carpal tunnel surgery, although these are fairly rare. Finally, recurrence cannot be ruled out, although it is not common.

The price for this type of intervention varies between 100 and 300 euros. The mutual insurance company may reimburse part or all of the excess fees.