Carpo tunnel Surgery

JessicaR
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I am waiting on a call from the plastic surgeon for my date for surgery. I have been dealing with my carpo tunnel for 10 years now and in the last year it has gotten tremendously worse. I fight for hours on end to regain the feeling in my hands. I am nervous as I have never ever had a surgery before. I have a few questions and was hoping to get some feedback from those who have gone through it or have a strong understanding as to the procedure and the recovery.

Is it better to go under or use local anesthetic?

Will they cast it for a short period of time? (im a klutzy girl)

Do they give you anything to take during the recovery?

I have 4 months off of work in the summer if I get the surgery close to the beginning of the summer will I be ok to go back to my job in September? (I work at a smoothie bar making smoothies hard on my hands)

I cant think of anything else at the moment but I am sure I will soon..

I appreciate the feedback from those who are willing to respond!!

Have a great day!!

jeremydpbland
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Most carpal tunnel surgery is done under local anaesthetic - basically because local anaesthesia is both safer and more convenient for the patient than general - no need to restrict food, quicker recovery, fewer serious complications etc. The outcome of the operation for the CTS is identical whatever kind of anaesthesia is used. The only caveat I would add over local anaesthesia is that one occasionally hears stories of it 'not working', ie patients who feel pain as soon as the skin incision is made and continue to do so through surgery. This is a result of poor anaesthetic technique or a surgeon who is in too much of a hurry to wait for it to take effect. I suspect that surgery which is undertaken while the patient is in pain is probably also less successful.

Cast - depends on the surgeon. Most surgeons do not use a cast after the operation but a few do and there is very little hard experimental evidence to suggest that one policy is better than another in post-operative care. You therefore need to ask your surgeon what his/her personal policy is I'm afraid.

Post-operative medication. Many patients seem to need nothing or just simple analgesics like paracetamol or ibuprofen, but as you will see from reading other CTS fora on the net there are some patients who do get quite a lot of scar tenderness and wrist and hand pain. Unfortunately their stories tend to be the most prominent on the internet because they have more incentive to seek help and support. As with casting individual surgeons vary in their recommendations so a lot depends on the policy of your surgeon.

Return to work is hugely variable, covering a range from back at work in 48 hours all the way up to 'wasn't ever able to return to original job at all'. Many of our patients are able to return to normal activities at 2 weeks. For those with more manual occupations we tend to suggest laying off the strenuous hand use for 4-6 weeks if possible. You should certainly be recovered from the surgery itself after 4 months holiday and only if you are unlucky enough to get serious complications from the surgery would you normally be unable to return to work.

If you have had nerve conduction studies done recently then knowing what they showed allows us to make some informed guesses about how long it is likely to take the nerve itself to recover once the surgery has taken the pressure off it. JB

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