Median nerve compression is a very common disorder. It can get compressed around the elbow, in the forearm and at wrist .At wrist joint, Median nerve passes through a narrow tunnel, along with tendons for finger movement. There are several ways it can get pinched at there and the collective symptoms are called carpal tunnel syndrome 

Health conditions like arthritis and diabetes are commonly associated with this syndrome. Pregnancy causes fluid retention in our body hence causes nerves to swell and entrapment. Repeated and prolonged forceful wrist and hand activity also increase the chances of median nerve entrapment at wrist.

Carpal tunnel syndrome comprises pain, heaviness, numbness, tingling in your thumb,index and middle finger. It starts with occasional symptoms and ends in complete sensory loss.These symptoms are usually worse during evening and night when you use your hand a lot during day time. Over time your grip gets weaker and you tend to drop things.

A detail history and physical examination is generally required for the diagnosis of nerve entrapment, but your doctor may also order tests like electromyography (EMG) and nerve conduction study (NCS), which basically test the function of median nerve, locate the site of nerve entrapment and also function of muscles supplied by the nerve 

There are nonsurgical ways to relieve symptoms of nerve entrapment by using pain killers, injections at wrist to reduce swelling and splints but you should always consult your doctor first as splints can also aggravate the entrapment.

Surgical options including releasing of median nerve at wrist it’s a day care procedure which including giving anesthesia locally on the area being operated ,There will be a small cut near palm and wrist which will be later on closed using few stitches .Hand will be dressed and a splint will be applied for a few days. After 10 to 12 days all the stitches will be removed and resuming of all activities will be allowed after 2 weeks.

After nerve release, gradual returning of sensation and function of muscles took from a few weeks to a year depending on severity of initial presentation, the earlier the release the better will be the outcome.  

FAQS

1. It’s been 3 days since my carpal tunnel surgery but I didn’t feel any return of sensations?

It took about 6 to 12 weeks for some symptoms to recover, but full recovery is expected to take upto a year. Recovery depends on severity of symptoms on initial presentations and if there is continuous numbness in fingers for some time before surgery, it is expected that recovery will take about one year.

2. Is Full recovery possible?

Generally complete recovery is possible in mild to moderate cases, some deficit is expected in very severe cases or cases with prolonged illness

3. my hand is experiencing currents like sensations in my finger after surgery, is this normal?

Yes, it’s normal . nerve recovery can present with current like sensations. Your surgeon can prescribe some medication which can reduce these sensations without affecting nerve recovery. 

 

Written by :  Dr. Obaidur Rahman

Copyrights: Pakistan association of Plastic Surgeons