Median nerve debridement to treat carpal tunnel syndrome is a last resort when conservative methods have not yielded satisfactory results. The operation can be of great benefit or even cure the problem; however, it carries risks and recovery times are long. The duration of convalescence varies from several weeks to a few months; It is also necessary to adhere diligently to the physiotherapy program to strengthen the muscles and heal the wrist and hand.
Steps
Part 1 of 2: Recover in the Short Term
Step 1. Know that you will most likely be discharged the same day as the operation
Carpal tunnel surgery is generally a "day hospital" procedure, which means you have to show up at the hospital on the agreed day, undergo the operation and go home after a few hours of observation; as a result, unless unexpected complications arise, you can expect not to sleep in the hospital.
Step 2. Put on a bandage or splint
You need to keep it on your wrist for about a week after the procedure (or as long as your surgeon recommends). The nurse or surgeon himself will apply the bandage or splint to you before discharge to keep your wrist and hand aligned during the early stages of healing.
- You will need to return to the clinic for a check-up after about a week.
- During the visit, the doctor will evaluate the condition of the wrist and will most likely remove the bandage or splint.
- He will give you further instructions on what to expect as your recovery progresses.
Step 3. Apply ice as needed
Studies that have analyzed the use of cold therapy following surgery show mixed results, meaning that some patients have noticed a change in pain level, while others have not enjoyed this benefit. You can try applying the ice pack for 10-20 minutes at a time to strategically manage pain in the days following the debridement; this way, you can control the pain and reduce swelling (inflammation) in the area.
Step 4. Consider taking pain relievers
You can start with over-the-counter ones to take as needed, such as acetaminophen (Tachipirina) or ibuprofen (Brufen); respect the dosage indicated on the leaflet or the doctor's instructions. For most patients these medicines are sufficient; however, if you are still in pain and the pain is crippling, you can ask your doctor to prescribe stronger pain relievers.
- The pain should subside within a few days to a week after the operation.
- If the discomfort increases instead of easing, call your doctor and let him know what's going on, so he can decide whether or not to bring the follow-up visit earlier.
Step 5. Know the complications to monitor
While recovering, it is important to be vigilant for any potential complications that may arise as a result of the operation. Here's what you need to pay attention to:
- Pain that steadily increases instead of decreasing
- Fever and / or redness, swelling, and discharge from the surgical cut (these symptoms may indicate an infection);
- Bleeding from the wound - this is an abnormal occurrence that must be evaluated by the surgeon.
- If you notice any of these complications, call your doctor to advise and evaluate treatment as needed.
Step 6. Stop smoking
If you are a smoker and have thought about quitting in the past, this is the time to do it; Smoking has been shown to interfere with the healing process, including after surgery. If you want to maximize your chances of hand and wrist recovery (not counting the other numerous health benefits), quit smoking.
- If you want to quit this habit, talk to your family doctor to help you.
- There are many medications that help manage the craving for cigarettes.
- There are also workarounds for taking nicotine as you begin the process of quitting smoking.
- Ideally, you should stop using tobacco products at least 4 weeks before surgery; however, it is always good to stop this habit at any time to support recovery.
Part 2 of 2: Recover in the Long Run
Step 1. Begin the physiotherapy program
It is a series of movements and exercises that improve hand and wrist motility; rehabilitation also focuses on strengthening the muscles to restore full limb function.
Physiotherapists are trained and qualified to help you recover muscle strength and joint motility in the carpal area; it is therefore essential to respect the program they have developed for you in order to heal properly after the surgery
Step 2. Change job duties as needed
When you are in full recovery, you must avoid stressing or tiring your wrist and hand by repeating the same activities that triggered the syndrome. For example, if you usually work at your desk typing a lot on the computer, you should know that this task can aggravate and not improve the condition of the operated limb (at least until you have long passed the post-operative phases).
- Ask your supervisor to perform duties that do not involve excessive use of the wrist and / or hand while you are recovering.
- Alternatively, if you can't switch activities, consider typing slower using only one hand to avoid worsening the situation and promoting healing. Consider using a trackball or touchpad instead of a mouse while you heal so that you put less pressure on the limb.
- If possible, you can consider taking time off work for a while so that duties don't interfere with recovery.
- Patients are advised not to resume work at their desk for at least a week after surgery or longer if they have to perform tasks that strain the wrist or hand more. Forecasts for a return to normal working conditions vary greatly according to the type of activity.
Step 3. Be aware of the prognosis
It usually takes several weeks, if not several months, before fully recovering from a median nerve debridement operation. In most cases, the results are good if the procedure goes smoothly (if complications have arisen during the surgery, this is a particular situation that must be assessed on a case-by-case basis with the surgeon). Assuming the procedure was successful and you followed the recovery protocol to the letter, you can expect an overall improvement in wrist function.
- There is a doctor's office that evaluated patients about five years after surgery.
- In this study, just over 50% of people complained of a slight return of symptoms after two or more years; however, for most of these, the complaints were mild and not so bothersome that they had to see a doctor.
Step 4. Know what to do in case symptoms recur
If you find that the pain and bothersome symptoms of the syndrome are still present or simply do not improve after debridement surgery, it is important to see your doctor again. It is possible that carpal tunnel syndrome is not the correct diagnosis in your case or that a problem has arisen. If the diagnosis was correct, the doctor will perform tests to evaluate the possibility of a second operation or alternative methods to control the pain, such as localized injections.
