The bane of data processors, carpenters, musicians, lumberjacks -- anyone whose job requires frequent, repetitive bending of the wrist -- carpal tunnel syndrome has been called the "new industrial epidemic." Although the prevalence of the condition is not known, the National Institute of Occupational Safety and Health reports that 15 to 25 percent of workers employed in construction, food preparation, clerical work, production, fabrication and mining are at risk for cumulative trauma disorders like carpal tunnel syndrome. The traditional surgical treatment for the condition required an incision in the palm.
While this procedure successfully relieved the wrist pain, tingling and numbness that characterize carpal tunnel syndrome, it often created incisional problems. The location of the incision increased the chances that small nerve branches in the hand might be cut, producing discomfort in the scar. Thanks to a new surgical procedure used at Baystate Medical Center, many of these problems are being eliminated. Baystate hand surgeons are the first in the area to utilize endoscopic surgery to treat carpal tunnel syndrome -- a technique that markedly reduces the size of the necessary incision, resulting in a faster recovery and, for many patients, a more rapid return to work.
"Although carpal tunnel surgery has been performed successfully for years, some of the minor problems associated with the open-palm method have prevented patients from receiving the full benefit of the procedure," says Jeffrey Wint, M.D., an orthopedic hand surgeon at Baystate who uses the endoscopic technique. "For people who work with their hands, the time spent recovering from a major incision in their palm can be a significant setback."
Causes and Cures Carpal tunnel syndrome arises when repetitive wrist motion causes swelling of the tissues within the carpal tunnel. The transverse carpal ligament is unyielding and the median nerve is compressed. The initial symptoms are wrist pain and a tingling sensation in the fingers, usually felt when the hand is at rest. If not corrected, the condition can produce numbness and weakness throughout the hand, making simple tasks such as holding a newspaper or turning on a faucet painful or impossible.
Surgery has been able to alleviate these symptoms by cutting the ligament that overlies the median nerve at the juncture of the wrist and hand. Until recently, however, the only means of access to the ligament has been through an incision in the palm.