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Will My Carpal Tunnel Come Back After Carpal Tunnel Release?

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Will my carpal tunnel come back after carpal tunnel release? A quick online search of carpal tunnel and carpal tunnel release may leave you with more questions than answers.

Many of the top listings on major search engines, usually sponsored advertisements to online businesses trying to sell carpal tunnel splints, provide very misleading and false information for those suffering from carpal tunnel syndrome.  Rather than encouraging patients to seek treatment from highly trained specialists, these websites use anxiety and fear to sell expensive splints that have very low success rates.

For example, one website called mycarpaltunnel.com quotes only 50 to 60% success rate for carpal tunnel release, with 85% of patients having their symptoms come back after surgery.  Unfortunately, this website does not provide any source of information on where these numbers come from.

Most likely, they are pulling these numbers out of thin air and making them up so that you will buy their $185 splinting product.

These sites say things like “…most patients report permanent tenderness over the point of incision for years after surgery. Patients also report a permanent loss of grip strength for years.” Again, this is nothing more than gossip and does not reflect the reality of undergoing carpal tunnel release or healing after a carpal tunnel release procedure.

On the other hand, the real peer-reviewed scientific data on carpal tunnel syndrome and carpal tunnel release tells a different story.

The most quoted value for recurrence of carpal tunnel syndrome has been since the 90s between 5% to 20%.  However as time goes and more high-quality studies are performed, many are questioning if there is truly such a problem as “recurrent carpal tunnel syndrome.”  As in most fields of medicine and surgery, there are many factors that go into the success rate of a surgery.  For example, how long was the carpal tunnel present prior to surgery?  How damaged was the nerve from years living with carpal tunnel syndrome?  What medical problems does the patient have?  Does the patient have diabetes and thyroid disease?  In properly conducted studies where these factors are accounted for, carpal tunnel syndrome does not seem to recur at all.

While recurrent carpal tunnel syndrome does exist and is a risk, if you have carpal tunnel symptoms, and you decide to have a carpal tunnel release, as a general rule you should not expect your symptoms to come back, ever.

References:

Kilinc F, Behmanesh B, Seifert V, Marquardt G. Does Recurrence of Carpal Tunnel Syndrome (CTS) after Complete Division of the Transverse Ligament Really Exist? J Clin Med. 2021 Sep 17;10(18):4208. doi: 10.3390/jcm10184208. PMID: 34575319; PMCID: PMC8470114.

Botte MJ, von Schroeder HP, Abrams RA, Gellman H. Recurrent carpal tunnel syndrome. Hand Clin. 1996 Nov;12(4):731-43. PMID: 8953292.

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Can I Have My Carpal Tunnel Released on Both Sides at the Same Time?

0127b 1What do I do if I have carpal tunnel on both sides?

Unfortunately, carpal tunnel syndrome is very common.  1 out of every 20 adult Americans has this condition, which can interfere with sleep, the quality of life, the use of the hands both at home and at work. Symptoms include numbness and tingling, especially in your thumb, pointer, and middle finger, waking up at night to shake your hands out, pain and numbness/tingling with activities that require gripping and repetitive wrist motions (holding a steering wheel, using tools, knitting, etc.).

Worse still, many have severe problems in both hands, and that may be YOU.

Sometimes simple treatments for carpal tunnel can help to quiet down your symptoms, especially if your symptoms came on recently.  These include oral anti-inflammatories such as steroids or NSAIDs, wearing a wrist splint at night, avoiding activities that make your symptoms worse, and even injections performed by a hand surgeon such as Dr. Nelson.

But what happens when you have carpal tunnel on both sides that does not respond to these measures?

Carpal tunnel release is a great treatment for carpal tunnel syndrome.  No matter how it is performed, it reliably relieves your numbness, tingling, and especially night pain and gripping pain due to carpal tunnel syndrome.

However, you may be worried about having surgery on both hands at the same time, also called “bilateral” carpal tunnel release.  Maybe you have concerns that you will not be able to take care of yourself or others (children, elderly parents), dress yourself, use the bathroom, prepare food, and participate in other activities of daily life. Or perhaps you are concerned that you will have to take too much time off of work, and that is something you can’t afford. Simply put, you may feel the need to have one “good hand” to help out while the operated hand heals.

But with new technologies and techniques, this is no longer the case.

In years past, carpal tunnel release was always done through an open incision in the palm.  While this can reliably treat and cure the symptoms of carpal tunnel syndrome, the incision in the palm can be painful especially in the early days and weeks after surgery.  This can require prolonged periods of healing where heavier activities or even simple activities around the house can be difficult for you or need to be avoided altogether.

However, Dr. Johnny T. Nelson uses a new technology to treat your carpal tunnel syndrome under ultrasound guidance.  Due to the extremely smallsonexhealed incision (about the size of a pea!) further back on the wrist, and no incision on the palm, the same release and relief of your symptoms can be performed while minimizing the period of healing pain after the surgery.

With ultrasound guided carpal tunnel release, almost all patients with carpal tunnel on both sides have it treated on the same day.  With ultrasound-guided carpal tunnel release, you may return to all activities immediately, including cooking, hygiene, dressing, and even work, including manual labor. There is no splinting or casting required, there is no heavy anesthesia on the day of surgery. Some patients who do very heavy work with their hands (for example, mechanics, plumbers, and other heavy laborers) may need to allow for 5-7 days for the area to heal.

In Dr. Nelson’s experience, he has yet to encounter a patient who has had ultrasound-guided carpal tunnel release done on both sides who wishes that they had it done only on one side.  However, many patients who had it done on one side only for fear of the healing process wish they had it performed on both sides.

So to answer your question: YES!  If you have carpal tunnel on both sides, and your symptoms are bad enough to need surgery, ultrasound-guided carpal tunnel release on the same day for both hands is often the best option for you. Click here for a complimentary printable handout about what to expect from ultrasound-guided carpal tunnel release.

Remember, every patient is different, your treatment depends on a one-on-one consultation with Dr. Johnny T. Nelson which includes a physical exam and discussion of your symptoms.  If you are a candidate for ultrasound-guided carpal tunnel release, even if on both sides at the same time, he will let you know.  Call 919-872-5296 for an appointment, or visit www.drnelsonctr.com to learn more.

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Announcing: January 10th Carpal Tunnel Open House

image2Join Dr. Nelson for a free, no obligation scanning open house on January 10th from 6-8PM at the Bone & Joint Surgery Clinic!

While many struggle with hand and wrist problems, it is very difficult to get personalized, trustworthy advice. What is my diagnosis? What should I do? Who can I trust?

NOW IS YOUR CHANCE!

Dr. Nelson will give a short talk about the two most common conditions of the hand and wrist: carpal tunnel syndrome and trigger finger. This will be followed by individual “mini consultations.” You will have an informal chat with Dr Nelson and he will tell you your most likely diagnosis. If desired, Dr. Nelson will also have an ultrasound machine to scan your wrist and measure your carpal tunnel nerve to confirm the diagnosis for you.

Visit www.drnelsonctr.com for more information or to RSVP. You may also call his office directly and RSVP at 919-872-5296.

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October 18th Carpal Tunnel Education Event – A Huge Sucess!

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The October 16, 2022 scanning open house at the bone and joint surgery clinic with Dr. Johnny T. Nelson was a huge success!

The lobby of the bone and joint surgery clinic was filled with attendees, some of whom drove several hours for the event, to educate themselves about carpal tunnel syndrome and for the opportunity for a free one-on-one consultation with Dr. Nelson.

Many were also very curious to learn about ultrasound-guided carpal tunnel release, new technology being offered by Dr. Nelson.  This ultra–minimally invasive technique of relieving carpal tunnel symptoms is changing the way that carpal tunnel syndrome is treated.

Dr. Nelson, one of the only orthopedic surgeons in the Raleigh Durham area to utilize in office ultrasound, also used ultrasound to confirm the diagnosis for many patients.  This was a special teaching and learning opportunity, Dr. Nelson was able to teach each attendee about the anatomy of the carpal tunnel, the surrounding tendons and blood vessels, and signs on ultrasound that the carpal tunnel nerve may be abnormal.

If you or someone you know or love has carpal tunnel syndrome, and you are not able to attend the scanning open house, call 919-872-5296 to schedule visit with Dr. Johnny T. Nelson.

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Free Scanning Open House at Bone & Joint Surgery Clinic – September 13th

Free Scanning Open House at Bone & Joint Surgery Clinic – September 13th

Do you wake up every night, shaking your hands out to make them stop hurting? Are you dropping things? Does pain or shooting electricity interruptsonex cropsome of your favorite activities?

More importantly: are you ignoring or suffering through these symptoms because you are worried about what the doctor will say you need to make it better?

Dr. Johnny Nelson is hosting a free educational open house and scanning event at The Bone & Joint Surgery Clinic on Tuesday, September 13th at 6PM. Dr. Nelson will briefly help to explain carpal tunnel syndrome in simple, easy-to-understand terms and will explain a new ultrasound-guided technique for treating carpal tunnel symptoms with the UltraGuideCTR device. Dr. Nelson will then be available for informal consultation and a free ultrasound exam of your wrist to measure your carpal tunnel nerve and confirm your diagnosis.

Dr. Nelson is the first and remains the only orthopaedic surgeon in the Raleigh-Durham area to offer ultrasound-guided micro-invasive carpal tunnel release.

Are you interested in attending? Does someone you know or love have carpal tunnel syndrome and are avoiding treatment? Call 919-872-5296 to RSVP or visit www.DrNelsonCTR.com for more information.

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Call 919-872-5296 to RSVP or visit www.DrNelsonCTR.com for more information.
traditional vs micro invasive ctr

What are the Different Types of Carpal Tunnel Release?

What are the Different Types of Carpal Tunnel Release?

Do you have carpal tunnel syndrome?

While it is important to be properly evaluated and diagnosed by a fellowship trained upper extremity specialist such as Dr. Nelson, symptoms of carpal tunnel syndrome include numbness and tingling in the thumb, index, and middle finger, “shaking out” of the hands either at night or during the day, pain, cramping or weakness of the hands, dropping objects, and frequently being awoken by the symptoms.

If you do have carpal tunnel syndrome, chances are if your symptoms are bad enough, you will benefit immensely from carpal tunnel release. When treated with carpal tunnel release in a timely manner, your sensation will improve, your strength will likely improve, your sleep will improve, and your overall quality of life will improve.

But there are different ways of performing carpal tunnel release.

Traditional Open Carpal Tunnel Release Incision

Traditionally, carpal tunnel release was performed in an open fashion. This means that an incision is made over the base of your palm that is 1 to 2 inches in length, and through this incision, your surgeon will release the tight tissues that are pressing on the nerve in your wrist. While this is a time tested approach, this method is more painful and requires increased healing time after surgery. The incision usually requires sutures, there will be redness and bruising, and more soreness around the area of the surgery. If you do heavier things either at home or at work with your hands, it may take more time, even up to 6 weeks, to get back to work and activities that require gripping and lifting.

From the standpoint of early healing, endoscopic carpal tunnel release has fixed some of

endoscopic carpal tunnel surgery pt1b
Endoscopic Carpal Tunnel Release Incision

these early healing problems. Endoscopic carpal tunnel release is performed through a very small incision at the end of your wrist, not on the palm, and does not require an incision over the palm skin. While final outcome and patient satisfaction is the same compared to open release after 3 months, endoscopic release helps patients to get back to full activities, gripping, lifting and working much sooner with less pain, stiffness, scarring, and soreness after the surgery.

But wait, it gets better!

Recently, new techniques have become available to perform carpal tunnel release without anesthesia, under ultrasound guidance through a very tiny “poke” incision in the wrist. This procedure has been termed “micro-invasive CTR,” and soon will be offered by Dr. Nelson.

Micro-Invasive CTR Incisions

A large percentage of the American population has carpal tunnel syndrome, and many of those patients have moderate to severe carpal tunnel syndrome. Unfortunately, many patients avoid carpal tunnel release because they feel they do not have the time to heal after surgery or they are afraid of the soreness and pain that is part of the healing process.

Micro-invasive CTR under ultrasound guidance is a new answer for these patients. This procedure does not require anesthesia, it does not require a tourniquet, and eventually it will be offered in the office setting, even on the same day that you see Dr. Nelson to talk about your symptoms and confirm your diagnosis.

Do you or someone you know or love suffer from carpal tunnel symptoms? Make a visit to see Dr. Johnny Nelson today to discuss your diagnosis and her treatment options. Microinvasive CTR may be the right treatment for you!

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