Doctors for Carpal Tunnel Syndrome in Delhi

The carpal tunnel is a narrow passage in the wrist through which the median nerve passes. When this nerve becomes compressed, it can lead to a condition called Carpal Tunnel Syndrome (CTS). This can cause pain, numbness, and tingling sensations in the hand and wrist, which can be quite uncomfortable. Treatment options for CTS depend on the severity of the symptoms. For mild to moderate cases, non-surgical treatments are usually recommended. These include:

• Wrist splinting
• Medications
• Physical therapy
• Ergonomic changes

Overall, with the right treatment and care, it is possible to manage the symptoms of CTS and improve the function of the affected hand and wrist. In cases where Carpal Tunnel Syndrome becomes severe, surgery may be necessary to relieve pressure on the median nerve. The primary surgical approach used for treating Carpal Tunnel Syndrome is referred to as carpal tunnel release. During this surgery, the surgeon cuts the ligament that is causing pressure on the median nerve, which helps to create additional space in the carpal tunnel and alleviate the pressure on the median nerve. The surgery can be performed with a traditional open incision or with a minimally invasive endoscopic approach.

There are many treatments that patients can consider, and if all non-surgical treatments are found to be effective, surgery may be eliminated as an option by the doctor. The following are suggested treatments for people suffering from carpal tunnel syndrome:

Physiotherapy : Physiotherapy can be an effective treatment for Carpal Tunnel Syndrome (CTS) and may be recommended as a first-line treatment, especially for mild to moderate cases of CTS. Physiotherapy for CTS typically involves exercises and manual techniques to improve wrist and hand function, reduce pain and inflammation, and address underlying causes of the condition, such as poor posture or repetitive stress injuries. There are several physiotherapy exercises that can alleviate the symptoms of CTS, such as:

• Ergonomic education : The person is made aware of using proper work techniques and maintaining posture to reduce strain on the wrist and hand. Ergonomic education for CTS may include instruction on proper workstation setup, including proper placement of the keyboard, mouse, and monitor to reduce stress on the wrist and hand. It may also include education on proper posture, hand and wrist position, and body mechanics during work activities.
• Manual therapy : With this technique, hand mobilization and soft tissue massage are taught to the individual, which may help improve blood circulation, reduce inflammation, and relieve pain.
• Customized stretching and strengthening exercises : Physiotherapists may recommend exercises that help improve smooth blood flow and strengthen the muscles of the hand and wrist.
• Nerve gliding exercise : This exercise aims to move the median nerve, helping to reduce compression and promote healing, improving range and mobility. These movements can help to reduce nerve tension and irritation, improve blood flow and oxygenation to the nerve, and promote healing.
• Splinting : Wearing a wrist splint at night and while performing activities that may aggravate symptoms can create less pressure on the median nerve. Splinting is typically recommended for mild to moderate cases of CTS, and can be worn during the day and/or at night while sleeping.

Medications : The patient can take orally administered corticosteroids, which can provide short-term relief, and local corticosteroids for long-term effects. Vitamin supplements such as vitamin B6 and omega-3 fatty acids can also be taken to improve nerve function and reduce inflammation. There are several medications commonly used to alleviate the symptoms of CTS.

• Nonsteroidal anti-inflammatory drugs (NSAIDs): These medications, such as ibuprofen and naproxen, can help reduce pain and inflammation in the wrist and hand.
• Corticosteroids : These medications may be injected directly into the carpal tunnel to reduce inflammation and swelling of the median nerve, which can alleviate symptoms such as pain, numbness, and tingling.
• Topical Analgesics : These are pain-relieving creams or patches applied directly to the skin of the affected area that can help reduce pain and discomfort.
• Antidepressants : To alleviate pain that is caused by nerve damage, doctors may prescribe certain types of antidepressants, such as tricyclic antidepressants and selective serotonin reuptake inhibitors (SSRIs).

Surgery : Surgical procedures are critical when the patient's condition becomes severe, as it can cause nerve damage, resulting in permanent immobility of the hand. There are two types of surgical procedures available for carpal tunnel syndrome in Delhi:

• Open surgery: During open surgery, the doctor makes a small incision in the palm of the hand to access the carpal tunnel and cut the ligament that is compressing the median nerve.
• Endoscopic surgery : Endoscopic surgery, on the other hand, involves making one or two small incisions in the wrist, inserting a camera and surgical tool to visualize and cut the ligament, and then applying sutures to close the area.

Home Remedies : Although home remedies are not a substitute for proper medical treatment of this symptom, they can relieve pain and inflammation. These include:

• Rest and ice : Applying ice packs and giving rest to the affected hand will help relieve pain and swelling.
• Hot and cold therapy : Alternating between hot and cold compression in the affected area can relieve the symptoms of CTS.
• Herbal remedies: Certain herbs such as ginger and turmeric have anti-inflammatory properties, and regularly consuming them can reduce inflammation and pain.

When a patient's condition does not improve or worsens despite conservative treatments such as wearing wrist splints, physical therapy, orally administered corticosteroids, and local corticosteroid injections, surgery may be considered as a last resort. If non-surgical options are not responding positively, healthcare providers may recommend surgery before the condition becomes worse. It is essential to consult a doctor at an early stage if the symptoms become frequent or persistent so that they can be treated at their root. Otherwise, in severe cases, surgery may be required to alleviate the symptoms.

Carpal tunnel syndrome is typically diagnosed through a physical examination and review of the patient's history and symptom pattern. Prior to the physical examination, the doctor may ask questions about the patient's work habits, lifestyle, and activities that could be contributing to their symptoms. Other tests that may be used include:

• Physical examination : This includes the Tinel and Phalen tests, which are used to diagnose carpal tunnel syndrome and assess the severity of symptoms. The physical tests include:
• a) Tinel test: The doctor lightly presses on the median nerve with a hand or instrument. If this produces a tingling or burning sensation in the patient, it is considered a positive sign of nerve compression.
• b) Phanel test: The patient is asked to hold both arms with the backs of their hands facing each other in a downward position for one minute. If this causes an aching or tingling sensation, it is a positive sign of carpal tunnel syndrome.
• X-ray : This test is performed to rule out other conditions that may cause similar symptoms, such as arthritis or a bone fracture, and to identify any abnormalities that may contribute to nerve compression in the carpal tunnel.
• Ultrasound : This non-invasive imaging technique helps identify the severity of nerve compression and the location of the affected area, providing valuable information to the doctor for identifying the best possible treatment.
• Electromyography : This test measures and records the electrical activity produced by muscle fibers, helping to identify muscle or nerve damage and interpret abnormalities in the graph to make a diagnosis.

Carpal tunnel syndrome surgery, also known as carpal tunnel release surgery, is usually an outpatient procedure. Here are the steps involved in the procedure:

• Anaesthesia : The patient is given local anaesthesia or light sedation to numb the surgical area and ensure a pain-free procedure.
• Preparation : The surgical area is cleaned and sterilized, and the patient's arm is positioned on the operating table.
• Incision : A small incision is made near the wrist at the base of the palm to relieve the pressure on the median nerve. There are two types of surgeries performed by medical practitioners depending upon the severity of the patient's condition:
• a) Open surgery : A small incision is made in the palm of the hand, exposing the carpal tunnel. Then, the ligament that is present above the carpal tunnel will be cut to relieve the pressure on the median nerve and to allow for free movement. Open surgery is generally considered safe and effective for treating CTS. However, it does require a longer recovery time compared to other minimally invasive techniques such as endoscopic or arthroscopic surgery. Patients may experience some pain and discomfort after the surgery, and may need to wear a splint or brace for several weeks to aid in healing.
• b) Endoscopy surgery : One or two small incisions are made, and through one port, a video camera is inserted to visualize the depth of the affected area. Through the other incision, surgical tools are inserted, and the ligament is cut, leading to relieving pressure on the median nerve. The surgeon uses specialized instruments to cut the ligament that is pressing on the median nerve, creating more space for the nerve and relieving pressure. Because the incision is smaller than in traditional open surgery, there is less damage to surrounding tissues, and patients usually experience less pain and scarring, and a faster recovery time.
• Closure : Once the procedure is completed, sutures are applied to close the incisions.
• Recovery : Recovery time varies depending upon the extent of surgery and an individual's healing time. Usually, it takes several weeks to several months to heal the wound.

The following are benefits a person may experience after successful completion of carpal tunnel surgery:

• Relief from symptoms: The primary advantage of carpal tunnel surgery is that it provides relief from all the symptoms associated with it, such as a tingling sensation, pain in the affected area, and weakness in the fingers and hand.
• Long-term relief : In most cases, the symptoms do not recur. However, certain lifestyle changes are necessary to prevent the recurrence of carpal tunnel syndrome symptoms.
• Improved quality of life : Before the surgery, the patient may have found it difficult to grip objects and carry out day-to-day tasks. After the surgery, within a few days or months, the person may be able to perform all normal tasks with greater ease.

Here are some common side effects of carpal tunnel syndrome surgery, although they may differ from person to person:

• Pain or discomfort: It is common to experience pain or discomfort after surgery, as the wound is fresh.
• Bleeding : In a few cases, there may be some bleeding after the surgery, which can usually be controlled with pressure and dressings.
• Infection : As with any surgery, there is a slight risk of infection after the procedure, but it is minimal.
• Swelling : There may be swelling after surgery as there is less mobility of the affected hand, which can result in swelling.
• Complications with anesthesia : In some cases, individuals may be allergic to the type of anesthesia given, resulting in complications.
• Numbness or tingling : There may be temporary numbness and tingling sensation after surgery as the affected area is healing and will take time to resolve.
• Scarring : There may be scarring in the affected area after surgery, but it may heal and fade away after a certain period of time.

Following are some steps that can help in the recovery process after carpal tunnel surgery:

• Follow the doctor's instructions - It is important to adhere to the post-operative instructions of the doctor, such as wearing a wrist brace, avoiding any activity that may cause strain on the affected area, and keeping the hand elevated.
• Attend physical therapy - Some physical exercises may be recommended by a doctor to help in the healing process and prevent any further damage and recurrence of the symptoms.Engaging in physical therapy exercises can be beneficial in enhancing the range of motion and strengthening the affected wrist and hand. Your healthcare provider may suggest working with a physical therapist to receive proper guidance and support during these exercises.
• Avoid heavy activities - Any activity that will cause muscle strain should be avoided, such as weight lifting, repetitive motions, and any heavy pressure on the wrist.
• Follow up with the doctor - It is important to visit the doctor's clinic for follow-up appointments, which will help the doctor to monitor the healing process and address any concern.
• Lifestyle Changes : If your CTS was caused by repetitive motions, your doctor may recommend making lifestyle changes to avoid aggravating the condition. This may include taking frequent breaks from repetitive activities, adjusting your work ergonomics, and performing stretching exercises.
• Rest and Recovery : It's important to rest and avoid strenuous activities for several days to allow the treated area to heal. Follow your doctor's instructions for post-operative care, including wound care and physical therapy.