Carpal tunnel release
Carpal tunnel release is an outpatient procedure performed to relieve pressure on the median nerve in order to reduce carpal tunnel syndrome symptoms, which include tingling and numbness in the fingers. Carpal tunnel release helps to restore muscle strength and dexterity to the hand(s), and is typically performed on patients who have had persistent (lasting longer than 6 months) symptoms that have not responded to conservative treatment methods.
Carpal tunnel release can be performed either through an open-surgery procedure or endoscopically; in both cases, the transverse carpal ligament is cut to relieve pressure on the median nerve. Each type of surgery has advantages and disadvantages. Open carpal-tunnel-release surgery involves a 2-inch incision in the middle of the palm; its advantage is that it provides the surgeon with a direct view of the treatment area, so there is less risk of accidentally damaging nerve tissue than there is with an endoscopic procedure. Endoscopic carpal-tunnel-release surgery is less invasive than open surgery; it involves only two tiny incisions, so patients have less postoperative pain and can return to work fairly quickly, assuming surgery was not performed on the dominant hand.
With both types of surgery, patients can return home the same day. Prescription pain medication may be necessary. Although some patients still have carpal tunnel syndrome symptoms after their procedures, most report that symptoms are significantly reduced.
Spinal Cord Stimulators
A spinal cord stimulator is an electronic device that is implanted in the body to help relieve chronic pain. Also known as a dorsal column stimulator, the device sends low electrical currents through wires placed near the spinal cord to treat pain. It allows patients to control when pain relief is needed or not.
The device does not cure chronic pain, but usually provides a 50% or greater decrease in pain and allows patients to be more active and have less of a need for pain medication. This procedure is usually considered when other solutions, such as surgery, injections and medications, have failed. Before implantation, patients will often be asked to go through a trial period with an external device. The trial will test patients' pain levels and see if they increase with the help of the device.
During the implantation of the permanent device, wires are fed with a needle and positioned on the spinal cord. The actual device is placed dependent on where the pain is. The device can be removed if necessary. The battery of the device must be replaced every 2 to 5 years. Complications rarely occur as the procedure is very safe and minimally invasive. Proper care following the procedure is required and includes limiting movement and avoiding driving for the first few weeks.