Fields of treatment / Neurosurgery / Carpal tunnel syndrome

Before your first visit, please make sure you have your imaging, scan and other test results available and ready. Please ask your healthcare provider or referring physician to post or email those documents to us. Failing to do so will make it harder for our specialist to evaluate your condition.

Symptoms affect the median nerve, which controls the thumb, index finger, middle finger and half of the ring finger. They include tingling and even burning in those fingers. Tingling and burning may travel up to the forearm and shoulder. The symptoms are very common at nighttime or early in the morning, they may even awake you from your sleep. Patients have reported that shaking their hands helped relieve their symptoms. As the symptoms worsen, patients may have cold sensation in their fingers, dry skin, altered skin coloration, increase pain, worsened sensitivity and clumsiness. Your muscles may eventually become smaller because of muscle atrophy.

Diagnostics

The doctor will determine that you have carpal tunnel syndrome by careful evaluation and examination. He or she will ask you about your symptoms. An EMG test to measure electrical activity in your muscles may be ordered to confirm the diagnosis.

Early management of symptoms is non-surgical. To relieve your symptoms, several options are available. These include activity changes, kinesiotaping, doing exercises, nonsteroidal drugs, steroid injections. Surgery is recommended if non-surgical treatments do not provide any relief. Carpal tunnel surgery is done on an outpatient basis.

Two different surgical techniques are available: open or endoscopic surgery. Both are known as carpal tunnel release. The goal of both procedures is to relieve pressure on your median nerve as it travels through the carpal tunnel. This allows for better blood flow to the nerve and your symptoms are relieved. Your doctor will talk with you about which procedure is best for you based on your preferences and severity of your symptoms.

To achieve the best outcomes of your surgery, it is necessary that you follow your doctor’s instructions regarding your post operative protocol. You will need to avoid any activities that may cause complications, wound infections or that may lead to recurrence of the disease.

Surgical options

• Open surgery-fully covered by Social Health Insurance
• Endoscopic surgery-additional fee is charged

Compared to open surgery, your hand will heal significantly faster. Your time spent in recovery will be shorter. You will be able to return to work faster.

You will be permitted to return to work within 8 to 12 weeks after open surgery, depending on the type of work you do and how much you will use your hand in your work. Minimally invasive surgery will allow you to return to work in 2 to 4 weeks on average. There is a smaller risk of complications as the skin incision known as portal is made in the part of hand that bears smaller load.

The incision for inserting instruments for the minimally invasive procedure is made in the patient’s wrist. This is done to protect the nerve during the procedure and to get better cosmetic results. The surgeon locates it fast and sees it easily. Then the surgeon cuts the transverse carpal ligaments, releasing the pressure on the nerve. The soft tissue surrounding the nerve is not damaged and remains functioning properly. A minimally invasive procedure reduces the risk of post op scarring. Open surgery may in some cases result in recurrence of the symptoms due to scar tissue.

Minimally invasive procedure with endoscopic guidance

One day Surgery Centre Hradec Králové now performs a new procedure to treat carpal tunnel syndrome. It involves a carpal tunnel endoscopic release. This surgery will be performed by our own MUDr. Petr Krůpa, Ph.D, who is an experienced surgeon