Carpal Tunnel Syndrome Treatment in India

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What is Carpal Tunnel Syndrome?

Carpal Tunnel Syndrome (CTS) is a common condition that affects the wrist, hand, and sometimes the entire upper extremity. It often occurs during pregnancy due to swelling caused by fluid retention. The carpal tunnel is a narrow canal located at the base of the palm, defined by the overlying transverse carpal ligament and wrist bones. Within this tunnel, the median nerve, a major nerve, and some tendons pass through, controlling movement and sensation of the hand, as well as providing muscle strength at the base of the thumb. While CTS affects parts of the hand served by the median nerve, such as the thumb and adjacent fingers, the ring finger, little finger, and outer edges of the palm remain unaffected as the median nerve does not extend to these areas.

Causes of Carpal Tunnel Syndrome

Carpal Tunnel Syndrome (CTS) is a prevalent disorder with various contributing factors, including:

  • Wrist dislocation and fracture
  • Swelling and inflammation around the tendons
  • Aberrant anatomy
  • Diabetes
  • Fluid retention
  • Tumors
  • Rheumatoid and degenerative arthritis

Symptoms of Carpal Tunnel Syndrome

Carpal Tunnel Syndrome (CTS) manifests through various symptoms, including:

  • Swollen sensation in the fingers.
  • Pins and needles sensation or numbness in the fingers.
  • Weakness in the hand.
  • Difficulty manipulating small objects.
  • Numbness or pain worsening at night, disrupting sleep.
  • Difficulty making a fist.
  • Tingling or burning sensations in the middle fingers, index finger, or thumb, extending up to the arms and reaching the elbows.
  • Difficulty gripping objects or maintaining a hold with the hands.

Diagnosis of Carpal Tunnel Syndrome

Accurate diagnosis of Carpal Tunnel Syndrome (CTS) involves several steps :

  • Electrodiagnostic studies, including nerve conduction and electromyography (EMG), are conducted to confirm CTS within the wrist and hands of the patient.
  • A thorough review of the patient's complete medical history is undertaken.
  • A comprehensive clinical examination is performed, during which the doctor may request the patient to execute specific tasks with their hands to assess the presence and severity of CTS.

Carpal Tunnel Syndrome Treatment

The treatment approach for Carpal Tunnel Syndrome (CTS) varies based on the severity of the condition. Here are some common interventions recommended by physicians:

  • Rest : Giving adequate rest to the wrists and hands throughout the day is essential.

  • Splinting : Wearing splints can help immobilize the wrist, relieving pressure on the median nerve.

  • Medications : Daily intake of nonsteroidal anti-inflammatory drugs (NSAIDs) and other over-the-counter pain relievers can help reduce inflammation and alleviate pain.

  • Occupational Therapy : Engaging in occupational therapy can help loosen the tendons in the wrists and hands, improving mobility and reducing symptoms.

  • Surgery : Surgical intervention may be necessary if wrist splints or medications fail to provide relief. Carpal Tunnel Syndrome surgery is typically performed under local anesthesia, with options including keyhole and open surgery techniques.

Keyhole Surgery for Treating CTS

Keyhole surgery, also known as endoscopic carpal tunnel release, involves a minimally invasive approach to treating Carpal Tunnel Syndrome (CTS). Here's an overview of the procedure :

  • Incision : A small, approximately 2cm long incision is made in the palm of the patient's hand.

  • Endoscope Insertion : An endoscope, a thin tube with a camera attached, is inserted through the incision. This allows the surgeon to view the inside of the wrist or to see images on a video screen.

  • Ligament Release : Through the endoscope, special instruments are used to carefully cut the transverse carpal ligament, which forms the roof of the carpal tunnel. This relieves pressure on the median nerve, alleviating CTS symptoms.

  • Closure : After the ligament is cut, the incision in the skin is closed with dissolvable stitches.

  • Duration : The entire keyhole surgery procedure typically lasts between 10 to 20 minutes.

Keyhole surgery offers advantages such as smaller incisions, reduced risk of complications, and quicker recovery compared to traditional open surgery techniques for CTS.

Open Surgery for Treating CTS

Open surgery, also referred to as open carpal tunnel release, is a procedure for treating Carpal Tunnel Syndrome (CTS). This approach involves making a single incision approximately 5cm in length in the front of the wrist, near the base of the palm. Through this incision, the surgeon gains access to the carpal tunnel, which is then opened up to relieve pressure on the median nerve. The transverse carpal ligament, forming the roof of the carpal tunnel, is carefully cut during the procedure. Once the ligament is released, the incision is closed with sutures. While open surgery involves a larger incision compared to keyhole surgery, it remains a reliable and effective option for treating CTS, particularly in cases where a more extensive release is necessary.

Bilateral Carpal Tunnel Syndrome

Bilateral Carpal Tunnel Syndrome affects a significant number of individuals annually, with many unaware they are experiencing it. Symptoms like nerve twinges, tingling sensations in the fingers, and fatigue are often overlooked. This syndrome results from pressure on the median nerve in both hands, stemming from various factors such as poor posture or swelling. Untreated, it can lead to persistent tingling, sudden bursts of pain, and numbness. In severe cases, individuals may struggle with finger movement or object manipulation. Fortunately, early diagnosis doesn't necessitate invasive treatments or surgery. Using wrist-friendly equipment to maintain proper wrist alignment during tasks like typing or using a mouse, incorporating simple exercises, and taking regular breaks can alleviate pressure. Additionally, wrist braces, available in diverse designs, offer another means of reducing strain.

Cost of Carpal Tunnel Syndrome Surgery

India offers numerous advantages for individuals seeking cost-effective Carpal Tunnel Syndrome surgery. One notable benefit is the significantly lower cost of the procedure compared to other countries. Moreover, hospitals in India provide access to state-of-the-art technology, ensuring patients receive advanced and effective treatment options.

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