Carpal tunnel syndrome
Overview of the treatment
The most important facts
Duration of surgery: approx. 5 minutes
Anesthesia: local anesthesia
Dressing: dressing change on the following day, then special plaster
Suitable if...
nocturnal pain, tingling in the fingers, or numbness are permanently bothersome.
night splints are no longer sufficient and the symptoms persist permanently.
you want to use the operated hand again immediately – without a plaster cast and without long downtime.
Methods & Variants
Early functional concept (standard)
Open release of the carpal tunnel via a very small incision, performed on an outpatient basis and under local anesthesia. No cast, no drainage – the hand is used again immediately after the operation.
Open instead of endoscopic – by choice
In our experience, endoscopic procedures offer no advantages over the open procedure with a very small incision. The safety regarding complete release and protection of the median nerve is very high.
Conservative options
A night splint prevents bending of the wrist, but usually only works temporarily. An exception is carpal tunnel syndrome during pregnancy, which often disappears after giving birth.
When the procedure is not suitable
The early functional concept is not suitable for patients who are immediately dependent on the heavy use of their hands: wheelchair and rollator users, people using walking aids, as well as patients with extreme obesity, immunodeficiency, or very severe co-morbidities. In these cases, we recommend inpatient treatment.
Patients taking anticoagulant medication and diabetics can easily be treated on an outpatient basis. Marcumar usually does not need to be discontinued or adjusted – details in a personal consultation.
Process – Step by Step
Diagnosis & Consultation
Carpal tunnel syndrome is primarily a clinical diagnosis: we have you describe the symptoms and we examine the hand. The pattern and extent of the sensory disturbances are key – for example, symptoms on the back of the hand speak against carpal tunnel syndrome.
Preparation
No unnecessary aspirin or ASA ten days before the operation – if there is an important reason, please continue to take it. A neurological measurement is common, but never decides alone on the necessity of the procedure. You can fill out the forms for the doctor's consultation in advance and bring them with you.
The Procedure
The operation is performed on an outpatient basis under local anesthesia and takes about five minutes; the total time in the clinic is usually half an hour. The procedures take place by appointment on Monday mornings and are billed through public or private insurance – without additional co-payment.
Follow-up Treatment
On the following day, the first and only dressing change takes place: the cotton dressing is removed, and the wound is covered with a special postage stamp-sized plaster – with which the hand can also be washed. The sutures are removed after one week; physical therapy is not necessary under normal circumstances.
Healing process
After one day, the operated hand is already partially ready for use again – after the dressing is changed, a special plaster protects the wound.
After one week, the stitches are removed; office work is, in principle, already possible again after one to two days.
After six weeks, even heavy manual work is possible again.
After a few months, sensory disturbances continue to recede, provided the nerve was not permanently damaged.
Risks & Safety
In the first few days, swelling, bruising, and a feeling of tension are possible; temporary sensory disturbances can occur. Wound healing disorders or inflammation rarely occur – especially in patients who have to exert a high load on the hand immediately. Scar discomfort or temporary irritation of the median nerve are also possible.
We minimize risks through a minimally invasive, tissue-sparing procedure, working under local anesthesia without anesthesia risk, dispensing with plaster casts and drainage, standardized hygiene processes, and a follow-up check the day after the surgery. Use your hand as it feels comfortable – whatever you like is allowed. In case of increasing swelling, severe redness, or fever, please contact us immediately.
Diagnostics & Alternatives
Neurological measurement, hand surgery examination to confirm the diagnosis
Night splint as a temporary conservative option
Waiting for only occasional, minor symptoms – prompt surgery for persistent symptoms
Inpatient treatment for patients who are not suitable for the early functional concept
