Two locations to choose from: 1000 Galloping Hill Rd #202, Union, NJ 07083 | 654 Broadway, Bayonne, NJ 07002
CARPAL TUNNEL SYNDROME
The best course of action is prevention. The goal is to reduce the amount of trauma
occurring to the tissues within the carpal tunnel.
The best course of action is prevention. The goal is to reduce the amount of trauma occurring to the tissues within the carpal tunnel. This can be achieved by concentrating on four factors: Position, Repetition, Speed, and Force. Position: Keep the wrist as straight as possible; do not bend the wrist forward, backward, or sideways unnecessarily. Use the whole hand and all fingers when grasping instead of just the index finger and thumb. Certain exercises may help strengthen your muscles so that you can maintain the proper position. Repetition: This is something to avoid doing for extended periods of time. Carpal tunnel syndrome is a "repetitive movement injury". Even light movements, if repeatedly performed, may lead to this condition. Give your hands a rest periodically. Speed and Force: Slowing down and easing up during repetitive movements is essentially similar to resting since damage to your tissues is reduced and recovery is enhanced. Use power tools if possible to provide you with speed and force. But a note of caution is due when using power tools: don't forget to use proper Position.
If you have already developed symptoms which may be due to carpal tunnel syndrome, there are three phases in wich a complete diagnosis is made: History, Physical examination and Lab tests. History: The signs and symptoms of carpal tunnel syndrome include tingling and numbness, pain, and weakness of the hands and fingers. We may ask you what aggravates the symptoms and what time of day are they worse. Physical examination: During the examination we look for things like swelling and loss of sensitivity in the hand. Lab tests: X-rays, nerve conduction testing, and muscle testing (electromyogram) help to document the presence and degree of tissue damage and whether complicating factors like fracture and arthritis
are also present.
There are two broad categories of treatments available for carpal tunnel syndrome and we will help you choose which of these is best for you. Medical treatment involves the use of medications and or splints. Medications can be used to reduce the swelling inside the carpal tunnel and relieve the pressure on the median nerve. These medications may be taken orally (non-steroidal anti-inflammatory drugs, which also reduce pain) or injected directly into the wrist joint (steroids). Splints help to keep the wrist in a straight or neutral positionand promote healing by limiting the amount of movement occurring in the tissue of the carpal tunnel.
Surgical treatment is reserved for those who have severe pain, persistent symptoms after medical treatment, or who are at risk of permanent nerve damage. The aim is to reduce pressure in the carpal tunnel by opening the roof of the tunnel. This is done by cutting the transverse carpal ligament. There are two types of surgical procedure: Open and Endoscopic; both take somewhat less than an hour to complete and may be scheduled as same day surgery. We can help choose the best type of surgery for you.
Please make arrangements to be accompanied home by a responsible adult after surgery. Do not eat or drink anything after midnight the night before the procedure unless you are instructed otherwise. Wash your arm the night before surgery.
Anesthesia is administered prior to the actual procedure so you don't feel pain during surgery. This may be local or regional, limited to your hand and arm, or general, making you sleep during the procedure. You may be given an intravenous line. A tourniquet is tied to your arm to stop the blood flow to your hand. The incision that is made in your hand depends on the type of surgical procedure that has been determined to be best for you.
Open Carpal Tunnel Release
An incision is made down the center of your palm. The ligament is then cut to relieve the pressure in the carpal tunnel.
The skin is then closed with sutures.
Endoscopic Carpal Tunnel Release
A small incision is made along the crease on the front of your wrist and a second small incision may be made across the center of your palm. An endoscope and other instruments are inserted into the incision or incisions. The endoscope contains a camera that sends a video image to a monitor where your doctor can see the ligament as he cuts it. The incisions are then sutured shut. If the endoscopic surgery cannot be continued safely, your doctor will change to the open procedure.
Risks of Surgery
The original symptoms may not be relieved, or there may be bleeding, infection, or rarely, nerve and/or tendon damage.
Immediately after surgery your hand will be bandaged and will be kept elevated to keep the swelling down; you should maintain the elevation when you are taken home. You may be given pain medications and be told to use an ice pack. It is important to keep the dressing dry so cover it with a plastic bag when bathing or showering. Dark blue or black discoloration of the hand after surgery is normal.You will be told about exercising your hand by opening and closing your fingers and squeezing exercises. You will probably be able to start light activities in one to two days. Avoid bending your wrist far forward or backward, and try not to bump the area around the sutures. We will schedule follow-up appointments so that we can make sure you are healing properly after surgery.
CALL US IF YOU NOTICE
Pale blue or white hand, pain that increases for more than a day and is not relieved by medication, loss of sensation, throbbing, or excessive swelling in the hand, or fever over 100 º F. If any of these occur after surgery, CALL US (Union office: 908-964-6600, Bayonne office: 201-858-1500).
1000 Galloping Hill Rd
#202, Union, NJ 07083
Tel: 908 964-6600
Fax: 908 364-1025
Bayonne, NJ 07002
Tel: 201 858-1500