Minimally Invasive Carpal Tunnel Solutions
If you start to feel pain in your thumbs or wrists and it is becoming difficult to perform daily tasks, you might be suffering from carpal tunnel syndrome.
Carpal tunnel occurs with the compression of the median nerve in the hand. “Of the nerves that go to your hand, the median nerve is the biggest in terms of how much skin it covers, but it’s the one nerve that goes through a confined space, called the carpal tunnel,” explains Dr. Christopher Jobe, orthopedic surgeon at Oroville Hospital. “Also in that space are tendons and occasionally some muscle. So, if there is any swelling in there, the nerve is the one that suffers and the person experiences numbness in the thumb and the next two and a half fingers.”
Some populations are more at risk, including those who are prone to inflammation and individuals who engage in certain repetitive motions—whether related to one’s career or other physical activities.
Treatment Options
Dr. Jobe describes the two types of treatment options: reduce the swelling or increase the area of the carpal canal. The first is attempted by having the patient wear splints at night, so as not to flex the wrist. An additional strategy to reduce swelling is with a cortisone injection.
The opposite option is the carpal tunnel release, where the space surrounding the nerve is made larger so the compression on the nerve doesn’t happen. While the traditional approach was to do an “open” surgery to create this space, advances in technology have allowed for a more minimally invasive procedure.
“I do an ultrasound-guided carpal tunnel release,” shares Dr. Jobe. “This is done through a small incision just proximal to the wrist. With the ultrasound, I can see the nerve, the arteries, the tendons, or any abnormal malformation that might get in the way. Then, I cut the transverse carpal ligament. Basically what I’m doing is making the volume of the carpal canal bigger and that takes the pressure off the nerve.”
What Can a Patient Expect Post-Procedure?
In Dr. Jobe’s experience, the ultrasound approach can be a permanent fix. Recovery is quite quick; once the pain subsides, patients are typically able to return to normal function on most tasks. However, certain motions can be problematic initially.
“The hardest thing for a carpal tunnel release patient to do is to get up off a chair, because this forces your wrist into hyperextension, and you’re pressing on the skin right over where we released that ligament,” explains Dr. Jobe. “I performed this procedure on both wrists of the head of our maintenance and security. He didn’t want to do them separately. So, we did both and he was back at work in four days. Granted, he still had pain when pushing off of a chair. But, he was able to do work.”
In regards to prevention, Dr. Jobe suggests looking into ergonomic work stations or adjusting your chair height while at the computer so your wrist isn’t put into a strained position.