CARPAL TUNNEL SYNDROME:
Why does surgery fail?
Carpal tunnel syndrome can be thought
of as two separate diseases:
Acute carpal tunnel syndrome - this is the most easily
treated portion of the disease.
consists of the acute symptoms - awakening at night, positional numbness, numbness and pain with use.
The second disease is the Chronic
Carpal Tunnel Syndrome - this is much more difficult to treat. This consists of the constant numbness and pain that
some patients experience. Many patients with long-standing carpal tunnel syndrome also have muscle weakness and atrophy.
While the acute onset symptoms usually respond immediately
or almost immediately to carpal tunnel release surgery; the long-standing, chronic numbness tends to take much longer to respond
to nerve release, if at all. This is due to the scar and fibrosis that occurs within the nerve due to the chronic pressure
on the nerve.
If you have had surgery for Carpal
Tunnel Syndrome but still have symptoms- the question that must be answered is:
Is this a failure of surgery, a recurrence of nerve compression, or was there such severe nerve damage
before the surgery that the surgery was unable to help.
A thorough history and examination when combined with new nerve studies often can help to answer this question.
Many patients ask about minimally invasive or endoscopic Carpal Tunnel release - we find that endoscopic
release is an excellent procedure, allowing quicker return to full function, less post-operative pain and a faster overall
recovery. Endoscopic release is our preferred method of treatment when surgery is necessary.