My name is Adrian Chojnowski.
I'm a consultant orthopaedic surgeon with special interest in hand surgery.
I'm based here at the Norfolk and Norwich University NHS Trust Hospital
Carpal tunnel syndrome is numbness, tingling and sometimes pains
in the finger, wrist and arm,
which can often strike you at night, waking you from sleep,
and can happen during the day when you're doing tasks with your hands.
You should have an operation
if your symptoms are troubling you to a significant degree
and also if you've tried non-operative techniques
to try and reduce the symptoms, and they haven't worked.
You should see your general practitioner.
You can try wearing splints at night which helps keep the wrists straight
and reduces the night symptoms,
often the most bothersome bit of carpal tunnel syndrome.
You can take anti-inflammatory drugs.
You can even try exercises which help the nerve to glide,
and sometimes that makes things a little easier, too.
Finally, you need to be checked over.
Occasionally, other medical problems can cause carpal tunnel syndrome,
for example, people with problems with their thyroid gland.
Finally, it's quite common to get it in pregnancy.
You should think about seeing a surgeon in consultation with your GP
when the other methods haven't worked
and the symptoms are really bothering you.
I'd ask my surgeon whether I actually had carpal tunnel syndrome
and therefore, would an operation relieve
the numbness and tingling I feel in my fingers?
The surgeon can tell from talking to you and examining your hand.
Occasionally they'll need some tests, nerve conduction studies,
which help to determine if the nerve is under pressure at the wrist.
It's important to make sure you don't have any medical problems
that might potentially be reversed or treated in other ways
that could also get rid of your carpal tunnel syndrome.
The operation is generally done as a day case procedure.
You only spend a few hours at the hospital.
Generally it's done under local anaesthetic.
That injection can sting a little bit but very quickly goes numb.
It's generally done as an open operation,
which means a cut through the skin at this level.
So a cut, the skin edges are retracted,
and then the ligament, which sits deep here, is divided.
That ligament springs apart and that removes the pressure from the nerve
which causes the tingling and numbness.
It's a little strange. You'll feel movements of your fingers,
but you should not feel any pain from the surgery.
Generally, the operation is quite quick, perhaps 15 or 20 minutes.
The surgeon will put some stitches in,
after looking out for any bleeding areas,
and then wrap your hand in a bandage.
Generally you'll go home after a few hours.
You'll have a big bandage on your hand.
It's important you keep your hand elevated and the fingers moving.
They might want to stiffen up a little bit.
Take painkillers. Keep the hand comfortable.
You'll have stitches in, and they'll need to be removed at about ten days.
This can often be done at the local surgery,
although sometimes the hospital may want to see you back.
Most patients can do their own physiotherapy at home
with finger movements which you'll be shown at the hospital.
Sometimes, if your hand isn't improving,
you might need to see somebody with an interest in therapy of the hand,
either a physiotherapist or an occupational therapist.
It depends which hospital you're at.
By the time patients come and see me in clinic,
they've been suffering the symptoms for some months,
have tried other treatments that haven't worked,
and for these patients, if we confirm they have carpal tunnel syndrome,
the vast majority will do extremely well after surgery.
They should be rid of their symptoms,
the tenderness in their scar will settle after a few months
and they'll make a good recovery.