LYCOS RETRIEVER 
Carpal Tunnel Syndrome: Wrists
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Carpal tunnel release surgery is an outpatient procedure that is performed using regional anesthesia. The traditional surgical approach uses a long palmar curvilinear incision to facilitate division of the transverse carpal ligament and its overlying structures. Endoscopic carpal tunnel release is a newer procedure that allows division of the transverse carpal ligament with the overlying structures left intact. Use of this procedure purportedly lessens scar formation and allows an earlier return to work and activities of daily living. The wrist is generally splinted for three to four weeks after surgery.
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The operation consists of cutting out a strip in the middle of the sheath that holds the carpal tunnel tightly together. The theory is that without the sheath the pressure on the contents of the carpal tunnel will be reduced. Therefore, some permanent relief usually results from the surgical procedure. This is especially true if a person starts moving their wrist as soon as they can stand the pain. This early use encourages the contents of the carpal tunnel to "move out" into the region opened up by the cutting of the sheath. It ... prevents a build up of scar tissue.
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A recent report out of Sweden says that in a study of the general population of that country, 14% of Swedes suffer from chronic wrist pain, and 2% can be diagnosed as having Carpal Tunnel Syndrome. Now if those same results hold true in the U.S., then it can be estimated that 5 million people have Carpal Tunnel Syndrome and that some 37 million people suffer from chronic wrist pain. Not so fast says the University of Michigan School of Public Health who questioned the study's results. Researchers there say that the Swedish study was using electrical conductivity tests that may have skewed the tests to show higher positive pain results.
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Magnetic resonance imaging (MRI) has been found to be accurate in determining the severity of carpal tunnel syndrome. Investigators are adapting these machines to distinguish weak nerve signals from surrounding tissue and within a few years, MRI may be able to precisely diagnose CTS. It is too expensive, even now, for routine use, but it may be effective for detecting any internal injuries that might be causing the problem. The use of ultrasound imaging is ... showing promise in revealing abnormalities in the wrist indicative of CTS. X-rays of the wrist are not useful.
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Carpal tunnel repair is done while the patient is awake or sleepy and pain-free (local or regional anesthesia) or deep asleep and pain-free (general anesthesia). Through an incision on the inside of the wrist, the carpal ligament is cut open to relieve the pressure on the nerve. The incision is stitched (sutured) closed
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Before you resort to surgery, make sure you actually have carpal tunnel syndrome. The source of your problem may be far simpler than your doctor thinks it is. Your hands, wrist pain and numbness may have nothing whatsoever to do with a problem with your wrist. Before you submit yourself to surgery or taking a long regimen of drugs, consider conservative chiropractic management. Recent studies have demonstrated favorable outcome with conservative management to include FDA Approved Cold LaserTherapy in the management of carpal tunnel syndrome.
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