Health and Disease information

Dr. Micah Jones – Carpal Tunnel Prevention and Surgery – LewisGale Physicians

(calm piano music) – My name is Micah Jones. I am a orthopedic surgeon at LewisGale Hospital. I subspecialize in adult hand, and upper extremity, as well as I do all the pediatric hand and upper extremity for the hospital and the surrounding areas. Prevention of carpal tunnel is somewhat of a controversial subject. The best way to prevent it is to catch it early, and to treat it conservatively.

With the night splinting, if you have diabetes or low thyroid, treating those appropriately with good sugar control, good normalization of your thyroid hormone, wearing a night splint, things of that nature. If there’s a repetitive thing that’s causing the carpal tunnel, for example in our literature vibration tools such as jackhammers, lawnmowers, chainsaws, those are things that irritate nerves very highly, and so wearing anti-vibration gloves can be preventative, things of that nature. But really catching it early on and trying to treat conservatively is the best way to prevent it from getting progressive and needing a surgery. Surgery for carpal tunnel is a same day surgery, takes me about an hour. What it involves is an incision of the skin, and then I have to find the special ligament that’s over the nerve, and I have to release the ligament off of that nerve. And then I go into the carpal tunnel and again, I look for that excess tissue to see if it’s thickened or redundant, and if it’s not, then I leave it alone.

There’s also other things I look for, such as a space occupying lesion that can be a little lipoma within the carpal tunnel, there can be a ganglion cyst in the carpal tunnel, things like that that are also putting pressure in the nerve so I explore the entire carpal tunnel to make sure that that’s not happening. After that, we sew you up with removable nylon stitches, and usually those are maintained for about 10 to 14 days, and then you see me back in the office, I remove those and I get you moving right away. The recovery to carpal tunnel is fairly benign. Once the sutures are out and your wound is healed, I let you have full range of motion, no restrictions, and I let you do basically anything you want to do as long as your wound is healed and you’re doing well from a functional standpoint.

Very rarely does carpal tunnel surgery require any physical therapy or occupational therapy after surgery..

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