Safer Surgeries, Faster Recoveries for Carpal Tunnel Syndrome

Buttoning a shirt. Tying a necktie. Opening a jar. Simple everyday tasks. But not for someone suffering with Carpal Tunnel Syndrome. Clair Farrell explains what it can be like for a sufferer of Carpal Tunnel. ” The pain was awful, just awful. And it really interfered with my ability to carry on any day-to-day activities. It was day and night the pain. And it came on rather abruptly, and just seemed to get worse and worse to the point where I really could not even do my job”. Carpal tunnel syndrome is a pressure on a nerve, called the medial nerve that travels through the “tunnel” found in the wrist surrounded by bones on one side and a thick, thick membrane on the opposite side. This tunnel not only gives passage to the medial nerve but also gives passage to nine other tendons. And whenever there are any structural changes, swelling, inflammation, it puts a pressure on the nerve causing tingling and numbness in the fingers producing the symptoms typical of carpal tunnel. That inflammation is most often caused by repetitive motion of the fingers such as typing on a keyboard.

In most cases of Carpal Tunnel Syndrome, the first course of treatment involves anti-inflammatory medication or the prescription of a splint or brace to be worn during working or resting hours. However, when these conservative methods fail, surgery may be required to prevent damage to the nerve and loss of function. The traditional method for releasing the carpal tunnel usually requires opening the palm, wrist and forearm with a conventional incision, which can lead to a prolonged and painful recovery. Recently a team of orthopedic experts with a company called AM Surgical has developed a revolutionary approach to carpal tunnel release. The proven technique involves the use of endoscopic visualization, and can be done on an out patient basis. The originator of the technique Dr. Ather Mirza explains. “We came up with the idea of doing it from a distal incision. That means an incision further up in the palm. And then we accomplish the surgery without any threat to those vital structures and avoid the complications the previous endoscopic technique had. To us that’s a big, big plus because it’s important to not injure the patient. The second most important thing we feel is that because it’s a small incision, the patient has much less postoperative pain. So much so that half of the patients did not take any pain medication.” Surgeons say the patients who have undergone this procedure not only report less post operative pain, but also achieve a quicker return to their normal activities. Clair was one of them. “I had absolutely no post op discomfort at all. Of course I went home the same day. I had minimal, minimal discomfort that day, I needed no pain medication at all and I went back to work the next day. I didn’t need to take any time off from work except for the day of the procedure.”

A quicker recovery has been shown to benefit more than just the patient. Faster return to work means less downtime, and therefore is more cost effective for companies. And fewer hospitalizations mean less of a drain on an already over-burdened healthcare system. “Studies after studies have been done to compare the open or the old conventional carpal tunnel technique and the new endoscopic technique. And these studies were all done at very famous institutes throughout the world. And the consistent outcome of these studies is that the patients who have endoscopic carpal tunnel release invariably went back to work much earlier than the ones with the conventional.” Says Dr. Mirza. But for patients like Clair, who had been suffering from Carpal Tunnel Syndrome returning to productivity is not the only advantage. Relief of the pain and the ability to once again enjoy life’s simple pleasures can be equally important. “I play the piano in fact in church; I accompany the choir in church. And I could not play the piano, my symptoms were so bad for two weeks before the procedure so I absolutely could not play the piano during that time, and then I’d say, well of course while I had the dressing on my hand I wasn’t able to play, but within two weeks after the surgery I was able to play again and I’m perfectly fine now, back to normal.”

For centuries the surgeon has been synonymous with exactness and precision. But even the most skilled hands can often be hampered by the restrictions of the scalpel and open technique. Today advanced endoscopy and image-guided technology are helping surgeons to see beyond these limitations.