If you’re living with chronic hand or wrist pain, chances are you desperately want relief. Many times, non-surgical treatment is quite effective as a remedy for hand and wrist pain. However, there are circumstances in which hand surgery is the only long-term solution.
So when is the time to consider hand surgery for carpal tunnel syndrome, rheumatoid arthritis, or another hand condition?
When do I need carpal tunnel surgery?
You may have carpal tunnel syndrome if you have:
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Numbness or tingling in the thumb, index, middle, or half of the ring finger
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Fingers fall asleep while driving, talking on the phone, washing your hair, etc.
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severe pain at night
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Pain that radiates to forearms, shoulders, neck
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drop objects
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objects falling out of hands
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weak grip strength
Pain relief is the primary purpose for performing most hand surgeries, including carpal tunnel release surgery. Individual pain thresholds vary, so some people allow the condition to progress longer than others before considering hand surgery. In most cases, carpal tunnel patients decide that hand surgery is necessary when they begin to experience numbness in their fingers, severe pain at night, and radiating hand pain.
There are three different surgical options to treat carpal tunnel pain:
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Open Carpal Tunnel Release: Traditional surgery with large incision, longer recovery period.
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Mini Carpal Tunnel Release – Traditional open surgery with a smaller incision.
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Endoscopic Carpal Tunnel Release (also known as the No Stitches Procedure): 10 minute minimally invasive procedure, no stitches, short recovery period.
Can you operate for rheumatoid arthritis?
Rheumatoid arthritis has no known cure. This is a chronic inflammatory autoimmune disorder, which means that the body’s immune system mistakenly attacks its own tissues. For this reason, rheumatoid arthritis treatments focus primarily on controlling symptoms and preventing joint damage.
You may have rheumatoid arthritis if you are experiencing:
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Tender, hot and swollen joints
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Morning stiffness that can last for hours
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Rheumatoid nodules: firm growths of tissue under the skin on the arms
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Fatigue, fever, weight loss
Since there is no absolute cure for rheumatoid arthritis of the hand, medications can reduce joint inflammation, relieve pain, and prevent or delay joint damage, but very little else.
The best treatment is to manage the symptoms of rheumatoid arthritis as well as possible from the beginning. Being proactive in this way will hopefully prevent or slow irreparable damage to your hands.
Unfortunately, many hand and wrist arthritis sufferers don’t take action until significant pain is felt and the damage has already begun. Severely damaged joints due to rheumatoid arthritis of the hand make hand surgery necessary.
If medications and other treatments fail to prevent joint damage caused by rheumatoid arthritis, there are several surgical procedures to consider:
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Total joint replacement: The damaged parts of the joint are removed and replaced with a prosthesis made of metal or plastic.
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Tendon repair: surgical repair of tendons around joints that may have become loose or torn
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Joint Fusion – For when joint replacement is not an option; two joints can be fused together to stabilize or realign a joint, often resulting in pain relief
It is difficult to regain full function of the fingers after damage caused by rheumatoid arthritis, but significant improvement in function, pain, and appearance can be expected after this type of hand surgery. Removing or repairing the arthritic areas will not eliminate the cause of the disease, which means that the problems may return, requiring additional attention from your hand doctor.
Is there a surgery to remove ganglion cysts?
Ganglion cysts are very common and usually appear on the wrist. The cyst is a pocket of fluid that has collected at a weak point in the ligament wall. Ganglion cysts are almost always benign, which means they are not cancerous.
In general, ganglion cysts do not cause pain or limit a person’s range of motion. Of course, this is not always the case. In some people, cysts like these can become chronically painful and need to be treated.
The least aggressive treatment for a ganglion cyst is rest. It is recommended for those who do not experience pain or discomfort from their cyst. A hand doctor will recommend immobilization of the cystic hand or wrist, either with or without a splint. Ganglion cysts may go away on their own, but only over time.
The next, more aggressive option is aspiration, which simply means draining the fluid that has accumulated in the cyst. A hand doctor, who will use a needle and syringe to remove fluid from the cyst, performs this procedure under local anesthesia. Aspiration is a good temporary solution with little to no recovery time. However, the cyst will likely recur, as the “root”, or sac, will eventually heal where it was punctured and gradually begin to fill in again.
Surgical excision is the most comprehensive treatment option to get rid of a ganglion cyst. Patients who resort to hand surgery usually do so because their ganglion cyst has become painful or uncomfortable. Close proximity to a nerve, for example, could cause great discomfort and pain, especially with range of motion.
Surgical removal, performed by a hand doctor, usually only takes 20 to 30 minutes. This method has the least chance of the cyst reforming. This is because the root, or sac, that traps the fluid is completely removed so it cannot close and fill again.
Ultimately, it’s your hands and wrists, and you only get one pair, so take care of them! It may be easier to ignore pain when it first occurs, but seeing a hand doctor right away to treat your condition could prevent you from needing surgery to correct the damage.