A�Carpal tunnel syndrome�is a result of compression of the median nerve as it passes through the wrist. Both these nerves cross at the front of the wrist within a passage known as the carpal tunnel. Many tendons pass through this carpal tunnel too and if any swelling occurs, the large median nerve can easily be compressed causing the carpal tunnel syndrome. The symptoms include pain, tingling and numbness in the index and middle finger and numbness of the thumb. Carpal tunnel syndrome can often be alleviated with splinting and medications. If these treatments fail to bring relief, an operation may be required.

Some people are at higher risk of developing carpal tunnel syndrome, including:

• Women between the ages of 40 and 60 years
• Pregnant women
• People with certain types of arthritis
• Anyone who experiences a period of rapid weight gain
• People who use their hands for repetitive movements (such as typists)

Symptoms

Symptoms of carpal tunnel syndrome often develop as follows:

• Restricted blood circulation is a contributing factor to�chronic carpal tunnel syndrome. Therefore, one of the early symptoms includes cold hands and warm forearms due to constriction of blood circulation in and around the carpal tunnel
• A burning pain that radiates up the center of the forearm and can travel as far as the shoulder and neck
• An overall decreasing grip strength as the hand muscles atrophy due to pain and lower levels of hand activity
• Clumsiness with hands. Routinely dropping objects or the inability to make a fist
• Loss of fine motor skills in the hand. Difficulty writing, tying a shoe, working a mouse, picking up objects, buttoning a shirt or coat, threading a needle, etc
• Weak hands and inability to support one's self with hands when balancing or climbing
• Inhibited hand and wrist movement due to pain, and numb tingling hands or tingling fingers
• Loss of feeling in the hand or fingers
• Swollen sensations in the hand or fingers
• Finger pain, finger numbness and/or finger clumsiness particularly in the thumb and/or in the index or middle fingers
• Constant aching of the upper shoulder and neck as pain stimulates the nerve path up to the nerve center in the brain
• Hand dysfunction can lead to lost earnings, time away from work and loss of self esteem as a contributor at work and at home, some suffers even experience depression

Causes

Any condition that exerts pressure on the median nerve at the wrist can cause carpal tunnel syndrome.� The main cause of carpal tunnel syndrome is incorrect posture, especially found among computer users and people working on ergonomic keyboards. But some people may simply be born with smaller carpal tunnels than other people do.

Carpal tunnel can also be caused by repetitive movements during assembly line work, wrist injury, or swelling due to certain diseases, such as rheumatoid arthritis.� Carpal tunnel syndrome from repetitive maneuvers has been referred to as a "repetitive stress injury".� Repetitive maneuvers that can cause carpal tunnel include:

• Awkward joint posture
• Direct pressure to the ligaments and bones
• High force
• Prolonged constrained posture
• Repetition
• Vibration

You may be given either local or general anesthetic. The surgeon makes an incision (usually less than five centimeters long) into the palm of the affected hand. If the carpal tunnel syndrome is particularly severe, this incision may need to be longer. The exposed tissue beneath is then carefully cut through�with a�scalpel. This second incision reveals the transverse carpal ligament which is the structure responsible for the compression of the median nerve. The ligament is cut and the incision in the palm is sutured closed. (The body’s healing process will rejoin the severed ends of the transverse carpal ligament and the resulting scar tissue shouldn’t press so hard on the underlying nerve.) One or both wrists may be operated on at the one time.

After the procedure depending on the anesthesia, your vital parameters would be noted; you may have your wrist placed in a sling to help reduce swelling following the operation. You may find your wrist is quite uncomfortable for a couple of days. A pain relief is given if needed. Advice is given to exercise your hand and wrist as soon as possible.

Some of the possible complications of a carpal tunnel operation include:

• Injury to the median nerve
• Damage to the ulnar nerve
• Injury to surrounding blood vessels
• The transverse carpal ligament isn’t cut through completely which means a second operation is needed

If you are discharged within a day or two of surgery, you will probably need some help around the house. Cold packs applied at regular intervals can help reduce post-operative swelling if any. Give adequate rest the hand as much as you can for at least four weeks following surgery.

The other general procedures are:

• Abdominal or Thoracic Aortic Aneurysm Surgery
  
• Abdominoplasty
  
• Hemorrhoidectomy�.� etc

Few Major Hospitals for Carpal Tunnel Release Operation are:

• Wockhardt Hospitals
  
• Apollo Hospitals
  
• Max Healthcare
  
• Piyavate Hospital
  
• Florence Nightingale Hospital
  

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