Carpal tunnel surgery and physical therapy

by Nathan Wei, MD, FACP, FACR

Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.

Click here: Second Opinion Arthritis Treatment Kit

Carpal tunnel surgery rehabilitation is probably the most important part of prognosis.

A splint may be advised for the post operative period, While the The pain and numbness may go away right after surgery, it may take several months to subside.

The time to return to work will be determined by whether it was the dominant or non-dominant hand that underwent surgery.

• Surgery on the non dominant hand may allow return to work anywhere from return to work within 1 to 2 days to 7 to 14 days depending on the type of work.

• Surgery ion the dominant hand may require 6 to 12 weeks for a full recovery before return to work duties. Physical therapy may speed recovery.

There is a shorter recovery period after an endoscopic surgery than after open surgery, because the procedure does not require an extensive incision.

The pain and numbness may go away right after surgery, or it may take several months.

Patients should begin doing active hand movements and range of motion exercises immediately. Therapists also use ice packs, soft-tissue massage, and hands-on stretching to help with the range of motion. Hand putty is often used. Squeezing and stretching this putty with the hand and fingers help speed recovery. Therapists also use a series of "fist" positions to encourage the finger tendons to slide within the carpal tunnel.

Surgery, per se, may be a thing of the past for carpal tunnel syndrome. Here's why...

A much newer and much less invasive technique that has excellent results is percutaneous ultrasound guided release. In this technique, a small needle is inserted using local anesthetic. Using ultrasound guidance, multiple small holes are made in the flexor retinaculum (the tough fibrous roof over the carpal tunnel that compresses the median nerve). At the same time, fluid is injected into the retinaculum to spread and weaken the fibers. At the end of the procedure, the wrist is flexed (bent) and the weakened retinaculum is released. A splint is applied and the patient has full use of their hand by the next day.

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