Syndrome du canal carpien

Carpal tunnel syndrome is a problem where a major nerve at the wrist gets squeezed as it passes through a tight tunnel, causing numbness, tingling, pain, and sometimes weakness in the hand and fingers. It often develops slowly and is very common, but there are good non‑surgical and surgical options when needed.​

1) What is this condition?

  • The “carpal tunnel” is a narrow passage in the wrist made of bone and a strong band of tissue; tendons and the median nerve pass through it.​

  • When swelling or crowding in this tunnel puts pressure on the nerve, people feel numbness, tingling, burning, or pain in the thumb, index, middle, and part of the ring finger.​

  • Symptoms often start at night or with repetitive hand use (typing, tools, driving) and may progress to clumsiness or dropping objects.​

2) How serious is it?

  • Mild to moderate cases mainly cause discomfort and sleep disturbance, but can usually be managed and improved.​

  • If pressure on the nerve continues for a long time, permanent nerve damage and muscle thinning at the base of the thumb can occur.​

  • Early diagnosis and treatment greatly reduce the chance of lasting weakness or numbness.​

3) Non‑surgical treatments

  • Night wrist splinting to keep the wrist straight, reducing pressure in the tunnel; often first‑line for mild cases.​

  • Activity changes and ergonomic adjustments (keyboard position, tool grips, rest breaks) to reduce strain.​

  • Anti‑inflammatory medicines and hand therapy to reduce pain and improve tendon and nerve gliding.​

  • Steroid injections into the tunnel to reduce swelling and provide stronger short‑ to medium‑term relief than splints alone.​

  • These approaches work best in mild–moderate disease and may be used to bridge to surgery in severe cases.​

4) Types of surgery that may be needed

  • Carpal tunnel release: cutting the tight band (ligament) that forms the “roof” of the tunnel so the nerve has more room.​

  • This can be done as:

    • Open surgery through a small cut in the palm.​

    • Endoscopic surgery using one or two smaller incisions and a camera.​

5) Goals of surgery vs non‑surgical care

  • Non‑surgical goals:

    • Reduce symptoms, improve sleep and hand function, and slow or stop progression without an operation.​

    • Provide relief while waiting for surgery or in people who cannot have surgery.​

  • Surgery goals:

    • Permanently release pressure on the median nerve to prevent further damage.​

    • Relieve or greatly reduce numbness, tingling, pain, and weakness, especially when symptoms are moderate or severe.​

6) How surgery can “fix” the problem

  • By cutting the tight ligament over the nerve, the tunnel becomes larger and the pressure on the nerve drops.​

  • Over time, the cut ligament heals in a lengthened position, maintaining more space permanently.​

  • As pressure decreases, the nerve can recover, and signals to and from the hand improve.​

7) Risks of surgery (general and specific)

  • General risks: infection, bleeding, poor wound healing, and anesthesia‑related problems (though most procedures use local anesthesia).​

  • Carpal‑tunnel–specific risks:

    • Temporary soreness and weakness in the palm and wrist.​

    • Scar tenderness or “pillar pain” (deep ache on either side of the cut) that usually improves over months.​

    • Very rare nerve or tendon injury, which could cause persistent numbness or movement problems.​

8) Chances this surgery will work

  • Long‑term studies show a clinical success rate of roughly 75–90% for carpal tunnel release.​

  • Most people have big improvements in night symptoms, pain, and function, with very low rates of needing repeat surgery (often under 5%).​

  • Results are best when surgery is done before severe, long‑standing nerve damage.​

9) Possible complications from the surgery

  • Infection at the incision, usually treatable with antibiotics and wound care.​

  • Prolonged scar sensitivity or palm pain requiring therapy or desensitization exercises.​

  • Incomplete relief or return of symptoms in a small percentage of patients, sometimes needing evaluation for other causes or rarely repeat surgery.​

10) Typical recovery from the condition (overall)

  • With early non‑surgical treatment, many mild cases improve or stabilize, especially if work and home activities are adjusted.​

  • Without treatment, symptoms usually worsen over time, with increasing numbness and possible permanent weakness.​

  • Even after symptoms improve, people often need to maintain good wrist posture and take breaks from repetitive tasks.​

11) Typical recovery after surgery

  • Most procedures are done as day surgery; the hand is bandaged, and light finger motion starts right away.​

  • Soreness and grip weakness are common for several weeks; many people resume light daily activities within days and desk work in 1–2 weeks, depending on job demands.​

  • Maximum improvement in strength and sensation can take 3–6 months, and sometimes up to a year.​

12) How long in the hospital

  • Carpal tunnel release is almost always an outpatient procedure; patients usually go home the same day.​

  • Hospital admission is rare and generally only needed for other medical reasons.​

13) Long‑term outlook

  • Long‑term outcomes after surgery are generally very good, with sustained symptom relief for most people.​

  • Recurrence or need for re‑operation is uncommon and estimated under about 5–15%, depending on definitions and follow‑up time.​

  • With or without surgery, good ergonomic habits and avoiding repeated heavy strain help protect the nerve over time.​

14) Need for outpatient follow‑up

  • Post‑op visits are used to remove sutures (if needed), check wound healing, and guide when to increase hand use.​

  • Therapy visits may be recommended for range of motion, scar management, and strengthening.​

  • People treated non‑surgically need periodic follow‑up to see whether symptoms are controlled or whether surgery should be reconsidered.