FAQ
The carpal tunnel is a passageway in the wrist formed by eight carpal (wrist) bones, which make up the floor and sides of the tunnel and the transverse carpal ligament, a strong ligament stretching across the roof of the tunnel. Running through the carpal tunnel is the median nerve, which supplies sensation to the thumb, index and middle finger and usually half of the ring finger.
Carpal tunnel syndrome is caused by increased pressure in the carpal tunnel resulting in compression of the median nerve or by narrowing of the tunnel from wrist injuries, inflammation or arthritis. The actual injury to the nerve is usually caused by lack of blood flow to the nerve.
Find out more about what we can do for Carpal Tunnel Syndrome here.
Numbness, burning and/or tingling of one or more fingers are the most common symptoms. Often these symptoms first occur at night and can wake a person from their sleep. Aching, burning and/or electric pain may extend into the fingers and up the arm to the elbow.
The symptoms can often be aggravated with certain activities such as gripping, using a telephone or holding a steering wheel while driving. In severe cases of carpal tunnel syndrome, clumsiness or weakness can occur. Other symptoms can include difficulty doing up buttons or picking up small objects.
For severe cases of carpal tunnel syndrome, a surgical approach will more than likely be recommended. Most people with carpal tunnel syndrome will eventually require surgery. For mild cases of carpal tunnel syndrome a conservative treatment approach can be taken, which usually involves splinting and avoidance of activities that provoke symptoms. Sometimes corticosteroid injections may be helpful in relieving symptoms.
Here at the Carpal Tunnel Clinic Gold Coast, Dr Maguire performs the surgery under local anaesthetic using ultrasound guidance. The procedure is called Ultrasound Guided Carpal Tunnel Release (USGCTR), otherwise known as ultra minimally invasive carpal tunnel release.
Ultrasound Guided Carpal Tunnel Release (USGCTR) is performed as an outpatient procedure (meaning it is done in a non-hospital setting) under local anaesthetic. A tiny 1 – 2mm puncture wound is made above the palm and Dr Maguire will cut (release) the transverse carpal ligament. This relieves the pressure on the median nerve. To watch a video of the procedure click here.
No sutures or stitches are required for the USGCTR procedure. A Steri-Strip and Band-Aid is used to cover the puncture hole. You will require a wrist bandage overnight but this can be removed the day after surgery. Usually, the wound is completely healed within three days and you can bathe as normal at this time if the puncture wound is sealed and dry. It is unlikely that strong painkillers will be required after Ultrasound Guided Carpal Tunnel Release surgery. Occasionally Panadeine Forte may be prescribed for the first night following surgery.
Dr Maguire will review you approximately two weeks post op. Nerve conduction studies will be done again at two, four and six months post op. These nerve conduction studies are bulk billed, meaning there is no additional charge for them. Nerve conduction studies are performed after the surgery to confirm that the nerve is recovering.
Post-operative pain is usually fairly minimal and is controlled by simple analgesics such as Panadol, Panadeine or Nurofen. Occasionally patients may require something stronger such as Panadeine Forte for the first night.
The local anaesthetic may last for approximately 8 – 24 hours. If you feel you need something stronger once this wears off, please contact Dr Maguire’s rooms.
The success rate depends on the severity of the disease. If it is mild or moderate, the success rate is extremely high. In severe carpal tunnel syndrome the prognosis is less predictable. Using the USGCTR technique Dr Maguire has yet to perform revision surgery. In severe carpal tunnel syndrome Dr Maguire may use PRP or Platelet Rich Plasma Therapy to help the nerve recover.
All surgeries at The Carpal Tunnel Clinic Gold Coast are performed without the need for general anaesthetic or sedation. This allows a much faster turnaround and most patients are in and out within one to two hours.
You can start using your hand the day after the surgery. The incision will be above the palm and will be covered with a dressing following surgery. You will also have a bandage wrapped around the hand and wrist for the first night. After the first day the bandage can be removed, however, we recommended keeping the dressing intact and dry for at least three days while the wound is healing. Please be aware the dressing is water resistant but not waterproof so you should not submerge the wrist in water for at least three days.
Grip strength will be slightly diminished because we are cutting the ligament, which attaches to the thumb and little finger muscles. Grip strength loss is variable but it usually recovers fully over three to four months once the ligament has healed. Some patients experience pillar pain (pain in the base of palm), which usually subsides within three to four months but can take up to 12 months to fully resolve.
Most patients are unable to drive for five to seven days post-operatively due to weakness with traditional (open) carpal tunnel surgery, however, with the ultrasound guided technique used by Dr Maguire patients may be able to drive the next day.
You will need to discuss this further with Dr Maguire at the time of your surgery.
This depends on your occupation. Non-manual workers such as administration staff may be able to return to work within days after the surgery. Heavy manual workers may not be able to return to work for several weeks and may need to be on restricted duties.
You will need to discuss this further with Dr Maguire.
If you would like to arrange an appointment with Dr Maguire, you will need a GP referral so you are eligible for the Medicare rebates. You can have your GP fax your referral to us on (07) 5531 3122 or it can be emailed to us at info@maguireupperlimb.com.au or info@thegcctc.com.au.
Once we have received your referral, Dr Maguire will look over it and determine if you need any further nerve conduction studies or x-rays to be performed prior to your appointment. If you have already had nerve conduction studies performed in the past but they are over three months old, these may need to be repeated.
One of our friendly receptionists will then give you a call to discuss your referral and will help arrange any tests that are required such as x-rays and nerve conduction studies. These tests are usually bulk-billed meaning you should not have any out of pocket costs for these additional tests if you have a Medicare card.
Yes, a GP or specialist referral is needed to allow access Medicare benefits and the Medicare Safety Net.