Carpal tunnel syndrome is a medical condition that causes weakness and/or discomfort of the hand due to the compression of the median nerve at the wrist. Approximately 75 million people worldwide are affected. Treatments are often very effective, especially when the condition is diagnosed and treated early.
The most common symptoms of carpal tunnel syndrome are numbness, pain, tingling, weakness, loss of strength, or pain in the hands that can spread from the fingers to the shoulder. Symptoms may occur in one or both hands, and often happen at night.
There is a space in the middle of the wrist called the carpal tunnel through which pass an important nerve (i.e., the median nerve) and nine tendons. The median nerve gives sensation to fingers and hands and enables their movement. The transverse carpal ligament covers the top of the carpal tunnel. Inflammation of tendons or the ligament can compress the median nerve and result in carpal tunnel syndrome.
Carpal tunnel syndrome may occur in the absence of a particular factor or as a result of a combination of factors that increase pressure on the median nerve in the carpal tunnel. These factors include:
- repetitive bending of the wrist and fingers;
- poor posture for prolonged periods;
- genetic predisposition;
- trauma or injury to the wrist (sprain or fracture);
- pregnancy, arthritis, amyloidosis, overactive thyroid gland, diabetes, acromegaly, estrogen or corticosteroid treatments, tumour of the tendon sheath, cyst on the wrist or menopause.
How is carpal tunnel syndrome treated?
Non-surgical treatments of carpal tunnel syndrome can include behavioural changes such as resting the wrist partially or completely (e.g., wearing a splint), taking medication to reduce symptoms (e.g., anti-inflammatories), or injecting cortisone into the carpal tunnel. Non-surgical treatments are especially effective in less severe cases of carpal tunnel syndrome.
Surgical options may include open surgery or endoscopic surgery. Both interventions reduce pressure on the median nerve by cutting the transverse carpal ligament. The carpal tunnel them becomes less narrow and there is less compression on the median nerve. Both procedures are effective, but endoscopic surgery generally allows for quicker recovery. With a surgical camera, the surgeon can peform the procedure through smaller incisions. Scars are smaller and heal more quickly, reducing postoperative pain. Surgery aims to restore normal function to the fingers and hand. Dr. Mario Luc and Dr. Jean-Paul Brutus are among the few surgeons who perform endoscopic carpal tunnel surgery in the Montréal area.
Frequently asked questions
- No symptomatic relief of carpal tunnel syndrome
- Neurotrauma injury
- Stenosing tenosynovitis (trigger finger)
- Recurrence: Although exceptional, it is a possibility. An electromyogram will be required. A second procedure may be suggested.
Endoscopic carpal tunnel surgery is only offered by means of a service agreement between an employer and Clinique Innovation regarding a company employee. This service agreement must be completed by your employer. Under this agreement, the employer confirms that he or she employs you.
Any service rendered by a professional on the basis of an agreement or contract with an employer for the purposes of providing insured services to his employees shall not be considered insured services.” (Section 22.i, Regulation respecting the application of the Health Insurance Act)
The cost of endoscopic carpal tunnel surgery, which is billed to your employer as per a service agreement, is $3,300 for one hand or $4,430 for both hands.
Several incorporated professionals have used this type of agreement to minimize recovery time in the treatment of carpal tunnel syndrome. Therefore, dentists, doctors, physiotherapists, etc. can access this type of service agreement through their incorporation.
If your employer does not wish to cover the costs of the surgical treatment, please contact the clinic of Dr. Jean-Paul Brutus, a hand surgeon who is not covered by the RAMQ. He can offer this type of surgery by billing the patient directly.
PLASTIC AND AESTHETIC SURGEON
Dr. Mario Luc
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