Hand nerve stenosis surgery in Iran – Carpal tunnel stenosis
What is carpal tunnel stenosis and how is hand nerve stenosis surgery performed?
Surgery for hand nerve stenosis or carpal tunnel stenosis is one of the types of treatment methods for hand nerve compression and is performed with the aim of relieving the pressure on the hand nerve. Hand nerve stenosis occurs when the main nerve of the hand or the median nerve (median) is under pressure for various reasons and cannot continue to move normally in the hand channel. Because the narrowness of the canal space causes the gradual adhesion of the nerve to the walls and causes serious complications. This complication usually occurs mildly and causes symptoms such as mild pain, local numbness, shooting and numbness.
As mentioned, the hand nerve is located inside the carpal tunnel. The carpal tunnel is a narrow space between the bones and muscles of the wrist and is responsible for protecting the hand nerve from impact and pressure. The median nerve is a set of nerves that control the hand and fingers, which extends from the neck to the wrist and directly controls the thumb, index and two middle fingers. The nerves of other fingers are also connected to the main nerves through the carpal tunnel. When the hand is in an unusual position and under pressure for a long time, or the tendons and ligaments of the hand are swollen due to various factors, carpal tunnel syndrome occurs.
Effective factors in hand nerve canal stenosis
Many factors are effective in the occurrence of carpal tunnel stenosis and ultimately lead to Hand nerve stenosis surgery in Iran. The main factor is people’s jobs that cause this complication. In fact, people who constantly use their hands and put pressure on their wrists can be candidates for this complication. Among the effective jobs, we can mention mechanical, labor, carpentry, blacksmithing, computer jobs, gardening, sailing, sewing, etc. Even continuous household activities can cause channel narrowing. Other factors that cause hand nerve tightness include:
- Making continuous and intense movements
- Moving heavy objects
- Continuity in performing delicate and repetitive tasks such as typing, writing and knitting
- Doing heavy hand and wrist exercises
- Constantly carrying and using mobile phones and tablets
- A collision resulting in a broken or sprained wrist
- Pregnancy in women
- Specific diseases such as diabetes, thyroid hypofunction or hyperfunction, joint rheumatism and Dupuytren’s contracture
- Hereditary factors such as problems in hand anatomy
Signs and symptoms of hand nerve canal stenosis
When carpal tunnel stenosis occurs, signs and symptoms also appear. Some of them are mild and others express the need for hand nerve stenosis surgery. Among the most common symptoms are:
- Mild pain in the wrist and palm
- Numbness in the palms and fingers
- Burning sensation
- Hand falling asleep when awake or resting
- Weakness in hand muscles and inability to lift objects
- Poor response to sensory stimulation
- Inability to make fists and control them
- Swelling of the wrist
Many of these symptoms may appear both awake and asleep and make you uncomfortable. When the symptoms appear only in sleep, it can be said that the complication is mild. But when they appear both awake and in sleep and frequently and with intensity, the need for hand nerve stenosis surgery will be doubled.
Note that in mild cases of canal stenosis, the duration and intensity of the symptoms are short and transitory and occur mostly in the late hours of the night and during sleep. Of course, during the day and when lifting things such as mobile phones or books, there is a possibility of pain, but by shaking the hand or pressing the wrist, the pain is relieved.
Methods of diagnosis of hand nerve canal stenosis
Physical examination
One of the ways to diagnose the problem is to visit a doctor to examine the appearance of the hand and wrist. For this, the doctor will use simple physical methods to analyze and investigate the complication. Among these tests, the following can be mentioned:
- Creating pressure or trauma in the median nerve and checking the possibility of numbness or burning in the fingers
- Bend your wrists or make fists for a few minutes
- Examination of the sense of touch of the fingertips with special devices
- Examination of the weakness of the muscles of the fingers and wrists
Conducting medical tests
The doctor may use electrophysiological and imaging tests for detailed analysis and to confirm or reject the need for Hand nerve stenosis surgery in Iran. Performing these types of tests is necessary to check the condition of the median nerve and can provide additional information to the doctor. These tests include:
Ultrasound: This test is performed using high frequency waves to image the tissues and bones of the wrist and hand.
X-rays: X-rays are used to examine bone tissues in order to identify fractures, ligament tears, or arthritis.
Nerve conduction or NCV: This test is performed to detect nerve dysfunction during the transmission of motor signals. The scope of this test is the arm, wrist and fingers.
Electromyogram or EMG: The purpose of this test is to detect possible damage to muscles and muscle nerves.
Types of treatment methods without surgery for hand nerve stenosis in Iran
As you know, one of the ways to treat carpal tunnel stenosis is surgery, but there are other methods to treat the condition less invasively. These methods are used when the signs and symptoms are mild and temporary.
Physiotherapy: For quick and successful treatment, many doctors use physiotherapy using techniques such as electrotherapy, ultrasound, infrared and paraffin. This method can reduce the possibility of recurrence of the complication.
Laser therapy: By using laser, it is possible to remove the problem and remove the pressure from the nerve of the hand without surgery and high invasiveness.
Acupuncture: One of the oldest methods of treating the problem without surgery is hand nerve stenosis and it is done using long and thin needles. These needles can penetrate deep into the canal and remove the nerve adhesion. This method is very useful for people who are unable to take medicine due to digestive, liver or kidney problems.
Tipping: It is a very simple and inexpensive method and is done using medical adhesives. This method easily reduces the pressure on the canal, but the treatment is not definitive.
Performing Hand nerve stenosis surgery in Iran
Carpal tunnel surgery is one of the most definitive and, of course, the most invasive methods of treating the condition. When the condition has progressed to such an extent that pain and numbness and other symptoms are continuously created in the area and non-invasive treatments such as exercise, medicine, physiotherapy, etc. are not effective, surgery is absolutely necessary and required. Of course, the surgery is not very long and complicated and is mainly performed on an outpatient basis with local anesthesia. To do this, only a small incision is made in the hand so that the endoscopic device can be inserted into the area.
After the surgery, all the signs and symptoms will disappear. But for a complete recovery, the necessary care and examinations must be done for several months.
After the surgery, all the signs and symptoms will disappear. But for a complete recovery, the necessary care and examinations must be done for several months.
Before hand nerve stenosis surgery
Before performing the surgery, the doctor performed the necessary examinations and tests of the target area to have a complete understanding of the complication. Also, the doctor has examined the general health of the patient’s body to find out about the limitations. Among the things to check about the patient, it can be mentioned the absence of history of previous diseases and operations, special diseases, not taking prohibited drugs, smoking and alcohol abuse, etc. Of course, the mental and psychological condition of the patient and family members will also be examined in counseling sessions before surgery. This information can determine the condition of the patient after surgery. Finally, the doctor will provide you with information such as the type of surgery, description of the operating room, time and duration of the surgery, description of the risks and complications after the operation, etc.
How to perform Hand nerve stenosis surgery in Iran
In the first stage of the surgery, depending on the location of the complication and its severity, the doctor will inject you with some local anesthetic or general anesthesia so that you don’t have any pain or discomfort during the surgery. Then he chooses the desired method and starts the surgery.
One of the newest and best surgical methods is the endoscopic method. In this method, the doctor makes a small incision in the patient’s hand and inserts the endoscope arm. This arm has a small camera, a light source and a claw. By using this device, many complications can be solved.
Of course, in some situations, the complication may be caused by tendon rupture. In such a situation, the treatment cannot be done using endoscopy and it is necessary to perform open surgery. In this case, the doctor creates a big gap in the patient’s hand and wrist so that he has enough space to restore the retracted tendon and can perform the repair well.
If the pressure is due to swelling. Hand nerve stenosis surgery in Iran is much simpler and the doctor can remove the swollen tissue and relieve the pressure only through a small incision.
After the surgery is completed and the problematic factors are removed, the doctor closes the incision using absorbable sutures to repair the desired area. After stitching, the incision is bandaged. If you take care of the wound and change the dressing regularly, very few effects of cuts and stitches will remain on the skin.
One of the newest and best surgical methods is the endoscopic method. In this method, the doctor makes a small incision in the patient’s hand and inserts the endoscope arm. This arm has a small camera, a light source and a claw. By using this device, many complications can be solved.
Of course, in some situations, the complication may be caused by tendon rupture. In such a situation, the treatment cannot be done using endoscopy and it is necessary to perform open surgery. In this case, the doctor creates a big gap in the patient’s hand and wrist so that he has enough space to restore the retracted tendon and can perform the repair well.
If the pressure is due to swelling. Hand nerve stenosis surgery in Iran is much simpler and the doctor can remove the swollen tissue and relieve the pressure only through a small incision.
After the surgery is completed and the problematic factors are removed, the doctor closes the incision using absorbable sutures to repair the desired area. After stitching, the incision is bandaged. If you take care of the wound and change the dressing regularly, very few effects of cuts and stitches will remain on the skin.
Risks and complications after hand nerve stenosis surgery
After performing any type of surgery, there are always risks and complications will be seen in the patient’s body. The type and severity of these side effects are different depending on the type of operation, the amount of incision, the chosen method for surgery, the nature of the patient’s body and medical records. Among the most important complications after carpal tunnel surgery are:
- Internal or external bleeding
- Formation of blood clots in the canal tissue and veins
- wound infection
- Complications from anesthesia
- Skin complications and abnormalities at the wound site
- Numbness in hands and fingers
- Skin swelling and inflammation
- The wound remains open for a long time
- Swelling of wrists and hands
- Damage to tendons and nerves
- Hand muscle injuries
Rest period and recovery period after surgery
After Hand nerve stenosis surgery in Iran, the doctor determines the recovery period and resting time for you, depending on various factors, including the type and difficulty of the operation, the severity of the complication, side effects after the operation, etc. Of course, this does not mean determining the time to do daily activities or to do long-term and heavy tasks. The minimum time required to improve and reach suitable conditions for starting simple tasks and mobility is about one month. But you will need at least 3 months to do heavy work and intense activity.
During this period, the patient must visit the doctor periodically and perform basic examinations and health tests. These items are very necessary and necessary to measure the health of the wrist and hand. When working with the items, it is better to observe the following items:
- Avoid smoking and alcohol.
- Change the dressing regularly and clean the wound.
- Do not do strenuous activities without consulting your doctor.
- Avoid taking different and unnecessary medicines.
- Go to physical therapy sessions as prescribed by your doctor.
- The week after surgery, use light exercises.
Important points in the prevention of carpal tunnel stenosis
The best way to prevent carpal tunnel stenosis and hand nerve stenosis surgery is to observe the following so that you never have such problems.
- After doing heavy work with your hands, it is better to take the pressure off your wrist and carpal tunnel by using massage and relaxing your hand muscles.
- Avoid writing or typing for a long time and use massage while doing this. Stretching can also be very helpful.
- It is better to use both hands during long-term activities and rest them in turn.
- Avoid stretching or excessive pressure on the wrists and fingers and avoid bending them too much.
- When sitting for a long time, it is better to put your body and hands in a standard position so that there is no pressure on them.
- Avoid long and intense activities in cold environments and try to keep your wrists warm.
- Use a suitable wristband during exercise.
Hand nerve stenosis surgery in Iran 2022
