Frequently Asked Questions
Why does my foot look different after my knee replacement surgery? Should it hurt to have sex after a C-section? How can I relieve the pressure on a trapped nerve? Our FAQ page has the answers you need to kick chronic pain for good.
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What should I expect during recovery from ultrasound-guided carpal tunnel release surgery?
Please note that not every case is the same. There may be factors that change your expected recovery situation, and we will discuss these possibilities with you during your examination.
On average, however, you will be wide awake during the procedure, so no grogginess will be present afterwards. However, should patients wish to have sedation arrangement for this can be provided in advance. The total time you should spend with us is about 1 to 2 hours, with a fraction of that being the procedure itself.
Your incision may be closed with adhesive bandages or a single tiny suture if needed, but you will not have to immobilize your wrist. A Band-Aid or light dressing will be applied over the incision. Standard over-the-counter medication should be all you need to manage discomfort after surgery; however, stronger medication will be prescribed if needed.
Recovery from the soreness of surgery typically takes 3-6 days, compared to weeks with other methods of carpal tunnel release. Resolution of the nerve symptoms of carpal tunnel vary for every patient depending on many factors – including length of time you have had the nerve compression, and the severity of the compression.
The worse the disease, the longer it can take for the nerve to recover. Moderate nerve symptoms are expected to resolve very quickly; frequently the symptoms of numbness, tingling, and pain that were present prior to surgery can resolve within hours, days, or weeks.
What are the benefits of carpal tunnel release with ultrasound guidance?
There are many! To name several1,2:
- A small incision (3-5 mm) above wrist crease on the forearm is all that is required compared to open scar on the palm of the hand or a potentially slightly larger incision with and endoscopic releases.
- The procedure itself takes only a matter of minutes.
- Carpal tunnel release with ultrasound guidance can be performed entirely within our office, with no need for a hospital or surgical center.
- Only local anesthesia is typically required.
- Sutures are rarely needed to close the small incision. Adhesive strips are often enough.
- There is no need for a brace or cast.
- The patient can return to most daily activities almost immediately (though we do emphasize caution – no reason to be fool hearty!
- Most patients will be able to return to work very quickly after surgery, typically within 3-6 days.
1. Rojo-Manaute JM, Capa-Grasa A, Chana-Rodriguez F, et al. Ultra-minimally invasive sonographically guided carpal tunnel release: a randomized clinical trial. J Ultrasound Med. 2016 Jun;35(6):1149-1157.
2. Henning PT, Yang L, Awan T, et al. Minimally invasive ultrasound-guided carpal tunnel release: preliminary clinical results. J Ultrasound Med. 2018 Nov;37(11):2699-2706.
How does carpal tunnel release using ultrasound guidance differ from other carpal tunnel release techniques?
More traditional forms of carpal tunnel release either involve an open incision or the use of an endoscope inserted through an incision in order to see where to operate.
Carpal tunnel release performed under the guidance of ultrasound uses an external means of determining where to operate, and a new instrument called the SX-One MicroKnife® is placed through a small incision to perform the release.
SX-One MicroKnife is a registered trademark of Sonex Health, Inc.
How fast do nerves recover?
How badly the nerve is injured will affect how fast it can recover. If a nerve is cut in half and sewn together, it can grow at the rate of an inch a month or a millimeter a day. If the nerve is mildly pinched but still functional, then it can recover function in a few hours or a few days.
As the nerve compression gets more severe or if it has been compressed a long time, it can take months for nerves to improve. The nerve will regenerate better in younger patients than in older patients. However, we do see nerve regeneration and functional improvement even in the elderly.
How long will it take to recover from my surgery?
Generally, post-operative instructions call for rest and limited movement in order to speed up the healing process and recovery time. The length of recovery varies with each procedure and is different for each individual. Bruises usually disappear within a few days, and most swelling is gone in a matter of weeks. Your scars will fade over time but are permanent. All patients recover at a different rates. Patients who have been in pain for years may take a lot longer to heal and feel better than those have have a fairly recent problem. Those patients who are already taking a large amount of pain medication will require more medication than those who are not taking large doses of medication. Each patient is a little different. Those who are more active before surgery and who are able to push through daily activities despite their discomfort, will be more active after surgery. Our favorite post surgical recovery "therapy" is water therapy. Getting in a swimming pool and walking in the water does wonders for the lower extremity patients.
What is tarsal tunnel syndrome?
Tarsal tunnel syndrome is a nerve compression disorder in which the main nerve to your foot gets pinched in a tight location. The tibial nerve branches into three nerves in the ankle -- the medial plantar, lateral plantar, and calcaneal nerves. Patients may present with slightly different symptoms, but most have some component of numbness, tingling, burning pain, or sharp stabbing electrical type pains that radiate into the sole of the foot and the toes. It is often worse with activities and better with rest.
How do I know if surgery is right for me?
There are several important factors that come into play when deciding whether surgery is the right option for you. One of the most important factors is your health. Being in good health greatly reduces the risk of complications occurring during surgery and leads to a speedy recovery. Next, you need to ask yourself what is your level of pain, discomfort, disability, or functional loss. Then, you need to understand the common and not so common risks of surgery and the healing process. Finally, you should be able to express your expectations to your physician. You should not proceed until you understand to potential risks for a procedure, and have a clear understanding of a reasonable expectation for what can hopefully be achieved.
Is peripheral nerve surgery safe?
All surgical procedures are accompanied by a certain degree of risk. Our expert team is dedicated to making your operation go smoothly. We careful review your medical history and current health condition before deciding if it is safe for you to proceed with surgery. It is important that you fully disclose all pertinent information so that we are able to make an accurate assessment of the risks involved. We will take every precaution necessary to reduce the possibility of any complications.
When do I consider an operation for a nerve problem?
First, this question assumes that there is an operation that can fix the problem the patient has. There are certainly some things we just simply can not improve, and referral to other specialists may be necessary. However, if we have a potential to make a difference with on operation, there is not a single good answer for this. Every patient has a slightly different story; every patient has a different personality; every patient comes to the office with different experiences and biases; every patient has a slightly different health back ground and medical risk factors. But I do try to present one common sense rule: if the symptoms that the patient has (numbness, weakness, pain, ect) extend beyond the mild annoyance and start to become intrusive to one's valuable life activities, then assuming reasonable risks for surgery, a patient may wish to begin to consider a surgical treatment option. Otherwise medications, stopping the activities that exacerbate the problem, and other life style changes are likely safer and may be as effective.
What happens during my initial consultation?
During your consultation we will carefully discuss your history and complaints. We will review your medical history and current health, define the problem, define what you would like to have made better. Then we will try to make a diagnosis or a list of possible diagnoses that could explain the current problems. Very commonly a patient will require further tests. These may be done in the office or in other locations. Frequently we will perform Neurosensory Testing in our office to evaluate the function of a particular nerve or set of nerves. Frequently we will perform nerve blocks to help target problem nerves to see if we can localize the source of a particular problem. Often patients may be referred for further imaging studies such as MRI or electrophysiologic testing to study the function of the nerves thought to be involved. If a diagnosis and a plan is generated and a surgical treatment plan is considered, then this is a good time to ask specific questions about the procedure so that you are fully prepared, mentally and emotionally, for surgery. We will discuss the results that can be achieved, with the aid of anatomic drawings. When a final decision is made you may choose to schedule a procedure with the staff during the appointment or call back at a later time to do so.