Carpal Tunnel Decompression
Procedure Waiting Times
Tollgate Clinic, Colchester
Waiting Times (October 2022)
Carpal Tunnel Syndrome (CTS) is a condition affecting the hand and the wrist.
- The main symptom is altered feeling in the hand,affecting the thumb, index, middle and ring fingers.
- Many people describe the altered feeling as tingling.
- Tingling is often worse at night or first thing in the morning.
- It may be provoked by activities that involve gripping an object, for example a mobile telephone or newspaper, especially if the hand is elevated.
Your Appointment and Treatment
At your initial consultation we will diagnose whether you have CTS and how severe it is. This may involve a study using a machine to see how well the nerve in your wrist is conducting small electric signals. We will offer you treatment options including splinting and injection for less severe cases, and an operation on your wrist (at another appointment) for more severe cases. We provide all follow-up care.
To learn more see our Carpal Tunnel Syndrome Patient Leaflet
A typical treatment plan might cost £1,100 and include an Initial Assessment and Surgical Appointment however a list of possible charges that may apply in certain circumstances are detailed below:
- Initial Assessment £200 (plus £50 if injection required)
- Follow-up Appointment, if injection required for 2nd hand – £150
- Follow-up Appointment, if required post-injection, to establish whether surgery is appropriate – £150
- Nerve Conduction Study, if required – prices will depend on patient choice of provider and location
- Surgical Appointment – £900
- Appointment for removal of stitches, if required- £100
- Follow-up Appointment with Surgeon – £150 (not normally required)
- Step 1 - Register with Tollgate Clinic
- Step 2 - Initial Assessment Session (15 to 30 minute appointment)
- Step 3 - Conservative Treatment (Splint or Injection during your initial assessment appointment)
- Step 4 - Nerve Conduction Study if necessary to confirm Carpal Tunnel Syndrome
- Step 5 - Surgery (30 minute Booked Appointment) No gowning and no need to be in a bed.
- Step 6 - Follow-up Assessment by Telephone
- Separate physiotherapy sessions are not necessary with this type of procedure.
- Return visit not necessary as soluble sutures are used.
Tollgate Clinic, Colchester
Q: What is it?
Carpal Tunnel Syndrome (CTS) is a condition where the median nerve is compressed where it passes through a short tunnel at the wrist. The tunnel contains the tendons that bend the fingers and thumb as well as the nerve.
CTS commonly affects women in middle age but can occur at any age in either sex. CTS can occur with pregnancy, diabetes, thyroid problems, rheumatoid arthritis and other less common conditions, but most sufferers have none of these.
CTS may be associated with swelling in the tunnel which may be caused by inflammation of the tendons, a fracture of the wrist, wrist arthritis and other less common conditions. In most cases, the cause is not identifiable.
Q: What are the symptoms?
The main symptom is altered feeling in the hand, affecting the thumb, index, middle and ring fingers; it is unusual for the little finger to be involved. Many people describe the altered feeling as tingling. Tingling is often worse at night or first thing in the morning. It may be provoked by activities that involve gripping an object, for example a mobile telephone or newspaper, especially if the hand is elevated.
In the early stages, numbness and tingling are intermittent and sensation will return to normal. If the condition worsens, the numbness and tingling may become continuous, together with weakness and wasting of the muscles at the base of the thumb.
Sufferers often describe a feeling of clumsiness and drop objects easily. CTS may be associated with pain in the wrist and forearm. In some cases, nerve conduction tests are needed to confirm the diagnosis.
Q: What is the treatment?
Non-surgical treatments include the use of splints, especially at night, and steroid injection into the carpal tunnel. CTS occurring in pregnancy often resolves after the baby is born.
Surgery is frequently required. Although CTS often affects both hands, it is best to operate on one at a time. If you need a second operation we can arrange this a few weeks later.
The operation involves opening the roof of the tunnel to reduce the pressure on the nerve (see diagram above: the roof of the carpal tunnel is called the transverse carpal ligament). The operation is performed under a local anaesthetic. Afterwards the site of the operation is covered by a small adhesive dressing. You will not need a bandage or a sling. The stitches in your hand will be removed at our clinic 8 days after your procedure or with your consent we may use stitches which dissolve and do not necessitate a return to the clinic. In this case the follow-up will be done by telephone.
The outcome is usually a satisfactory resolution of the symptoms. Night pain and tingling usually disappear within a few days. In severe cases, improvement of constant numbness and muscle weakness may be slow or incomplete. It generally takes about three months to regain full strength and a fully comfortable scar, but the hand can be used for light activities from the day of surgery. The more you use your hand after the operation, the faster it will recover.
Q: If I need an Operation, How Long will it Take?
If the conclusion from your first appointment is that you need an operation, we explain the procedure and answer your questions. If you are happy to proceed, you will then be able to book a second appointment for your operation. On average the operation takes about 20 minutes and you should bring someone with you to drive you home afterwards.
Q: Will It Hurt?
When the local anaesthetic is injected into the skin of the hand, you will feel some discomfort, but as soon as it takes effect, you should feel no pain. Afterwards you may be sore for a couple of days, and you might want to take a mild painkiller. You will be provided with complete instructions about what to do after surgery.
Q: How Soon Can I Go Back to Work?
If your job doesn’t involve heavy work, you can go back as soon as you feel ready. If it does, or if your job involves handling food or nursing sick patients, you should take a full week off. You will recover quicker the sooner you return to normal activities including work. Most patients can do all their normal work by two weeks after the operation; if you have heavy manual work, or work that involves a lot of repetitive hand and finger movements, you may need to start gently and it may take three to four weeks to recover fully, but it is still better to return to work early. If in doubt about returning to work, please ask us for advice. Most patients return to driving at one to two weeks after operation, once they are fully in control of the car.