Carpal Tunnel Syndrome

Carpal Tunnel
Specialist

Carpal tunnel syndrome is a progressive condition where the median nerve becomes compressed within the wrist’s carpal tunnel, causing discomfort, pain, tingling, or numbness in the hand and fingers. Dr. Oscar Brumby-Rendell offering tailored solutions as he evaluates your condition carefully and recommends the most suitable surgical approach, ensuring minimal scarring and optimal outcomes.

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What is Carpal Tunnel Syndrome

Carpal tunnel syndrome arises when increased pressure within the rigid bony-and-ligament structure of the wrist compresses the median nerve. Contributing factors may include joint swelling, inflammation due to conditions like rheumatoid arthritis, or anatomical changes from wrist injuries

Symptoms

Early detection is crucial. Common signs include:

Tingling, numbness, or burning in the thumb, index, middle, and half of the ring finger—often first noticed at night
Weakness in grip, and dropping objects due to thumb muscle (thenar) weakness
Discomfort extending to the forearm or shoulder; symptoms may vary by wrist position or time of day

If symptoms persist or disrupt daily activities, it's essential to seek assessment early; unaddressed compression can lead to permanent nerve damage.

Causes

The causes of carpal tunnel syndrome are at times unknown; however, the following often lead to the development of this condition:

Rheumatoid arthritis, gout, and other inflammatory disorders
Wrist fractures, dislocations, or bone spurs
Repetitive hand and wrist movements, particularly in certain occupations
Fluid retention during pregnancy, hormonal changes, or hypothyroidism
Personal factors such as diabetes, obesity, and female anatomy

Treatments

Non-Surgical Treatments

Generally, non-surgical treatment methods will be advised initially. Such measures include:

Using a split when sleeping to decrease pain
Resting the hand affected by overuse injuries
Swelling reduction through the application of ice packs
Physiotherapy
Swelling reduction via corticosteroid injections

Fluid reduction through diuretic medication, which promotes excretion through urine
Treatment of other medical conditions
Ceasing pain-inducing activities
Using a wrist brace or splint to immobilise the hand and wrist for 4-6 weeks

Consumption of medicines such as diuretics and nonsteroidal anti-inflammatory drugs
Specially designed exercises to stretch and strengthen the hand and wrist (only commence after symptoms have diminished)

Dr Brumby-Rendell may recommend surgical intervention if conservative measures have not resolved your symptoms.

Surgical Treatments

Dr Brumby-Rendell will perform a fairly simple operation if he sees that your condition requires surgical intervention. In this surgery, Dr Brumby-Rendell will cut the transverse carpal ligament, which lies above the carpal tunnel. This will release the pressure on the median nerve, which lies below the tunnel. Throughout your recovery period, scar tissue will form, which should prevent pressure build-up on the median nerve.

Minimally invasive, endoscopic (keyhole) measures are usually implemented by Dr Brumby-Rendell, but open methods are used when required. The latter requires a larger incision for surgical site visualisation.

Types of Carpal Tunnel Surgery

Endoscopic Carpal Tunnel Release Surgery
(Keyhole Surgery)

Endoscopic carpal tunnel release, also known as keyhole carpal tunnel surgery, is a minimally invasive procedure used to treat carpal tunnel syndrome. During this operation, Dr. Oscar Brumby-Rendell creates a small 10mm incision in the wrist and inserts a thin tube fitted with a tiny camera. The camera provides a clear view of the inside of the hand, allowing precise surgical release of the transverse carpal ligament while avoiding unnecessary tissue damage.

By reducing pressure on the median nerve, this technique effectively relieves the symptoms of carpal tunnel syndrome, such as pain, numbness, and tingling, while leaving only minimal scarring.

Patients often benefit from quicker recovery times, less post-operative discomfort, and a faster return to daily activities compared to traditional open surgery.

Open release

Open carpal tunnel release is a traditional surgical technique known by Dr. Oscar Brumby-Rendell. He’ll create a small 25mm incision in the palm, providing a clear view of the surgical site. This allows him to carefully cut the transverse carpal ligament, which reduces the pressure on the median nerve and relieves symptoms such as pain, numbness, and tingling in the hand.

Open surgery also enables the identification and treatment of other wrist conditions, including inflammation, ganglion cysts, or tissue abnormalities.

Every surgical approach, whether open or endoscopic, carries its own recovery timeline, benefits, and potential risks. After a thorough assessment of your symptoms, lifestyle, and medical history, Dr. Brumby-Rendell will recommend the most effective treatment option tailored to your individual needs.

Post-Surgical Recovery

Numbness of the fingers and hand may be experienced immediately post-surgery due to local anaesthesia effects. Shortly after your procedure, you may feel soreness or stiffness in the hand and wrist.

To reduce swelling, many patients must apply ice packs and elevate their hand. However, this is not required of all patients, and Dr Brumby-Rendell will recommend recovery practices before and after your surgery.

A dressing may be required for 2-3 days post-surgery if you underwent an open release procedure. Generally, the dressing covering non-absorbable stitches will be removed 2 weeks after your surgery at a check-up appointment.

Looking after your hand

To reduce swelling, ensure your hand is elevated above your heart.
Wear a splint (upon recommendation).
Apply ice packs to reduce swelling.
Ensure your wound remains dry and clean. When showering or bathing, apply plastic wrap to the surgical area.
You may be advised to partake in physical therapy to increase the strength of your hand and wrist.
Promote healing by refraining from smoking and eating a balanced, healthy diet.

After your surgery, you will be under movement restrictions, specifically with regard to strenuous activities, to promote proper healing and decrease risks of damage. Dr Brumby-Rendell will explain these restrictions.

Pain after carpal tunnel surgery

Most patients do not experience post-surgery complications. Some patients, however, may experience scarring, pain, infections, and nerve damage, which can lead to weakness, sensation loss, stiffness or paralysis in the wrist and hand.

Post-surgery pain is a normal part of recovery. For patients who experience post-surgery weakness or pain, this generally resolves independently within a few days to a few months.

Pain and inflammation can be reduced via over-the-counter medication (including Ibuprofen). If you require stronger medication, Dr Brumby-Rendell may prescribe such following a physical assessment.

Returning to work

Your surgery type, whether the affected hand is your dominant hand, and your occupation will determine when you can recommence work.

For example, you may be able to return to work within 7 to 14 days if your non-dominant hand underwent endoscopic surgery and your occupation requires only light movements.

Contrastingly, you may be unable to return to work for 6 to 8 weeks if your dominant hand underwent open release surgery and your occupation requires repeated or heavy movements (i.e., typing or manual labour).

Generally, Dr Brumby-Rendell advises that you do not recommence work for 2 weeks, and this will be re-evaluated at your 2-week check-up. Here, further recommendations will be given depending on your recovery progression.

Physio and Exercises

Flying and Driving

Frequently Asked Questions

Can carpal tunnel syndrome go away on its own?

Is carpal tunnel syndrome only caused by typing or computer use?

Does carpal tunnel syndrome affect both hands?

How long is recovery after carpal tunnel surgery?

Can untreated carpal tunnel syndrome cause permanent damage?

What’s the difference between carpal tunnel syndrome and other wrist problems?

Why Choose Dr. Oscar Brumby-Rendell?

Dr. Oscar Brumby-Rendell brings exceptional expertise in upper limb conditions, especially hand and wrist surgery. His approach to carpal tunnel syndrome combines:

Advanced surgical techniques (both keyhole and open)
A personalised, patient-centred philosophy that prioritises function, comfort and speedy recovery
Strong foundation in diagnosis, treatment, and surgical intervention for the hand and wrist