Sufferers of a common and agonising wrist condition that takes years to heal could get a pioneering new procedure that eradicates pain in minutes.
More than 340,000 people in the UK suffer with carpal tunnel syndrome (CTS) – an uncomfortable hand injury that occurs when a ligament above the narrow passageway in the wrist, known as the carpal tunnel, swells and compresses the main nerve.
The condition can cause debilitating symptoms including pain, pins and needles, weakness, difficulty gripping and numbness.
Previously, the only way to cure severe cases involved months of steroid injections and, if that was unsuccessful, an operation to open up the wrist and severe the ligament to relieve pressure on the nerve.
Now, doctors in Scotland have become the first in the UK to carry out a new procedure that takes just 15 minutes, has no incision wound and allows patients to return to work the next day.
Over 340,000 people in the UK suffer from carpal tunnel syndrome (CTS), an uncomfortable wrist condition (file photo)
The technique, ultrasound-guided carpal tunnel surgery, is widely used in Europe and experts say it is likely to be rolled out across the NHS in the next two years. ‘Patients benefit from reduced pain levels and recover more quickly than those who undergo the conventional op,’ says Dr Sally-Anne Phillips, consultant hand and wrist surgeon at the private Glasgow healthcare facility La Belle Forme.
‘We believe this could be adopted as a standard procedure within the NHS given its efficiency in both time and cost.’
CTS is often caused by repetitive hand motions, extending or flexing the wrist for long periods of time, or conditions causing joint inflammation, such as rheumatoid arthritis. Certain factors increase the risk of CTS, including pregnancy, obesity, diabetes, a history of wrist injury and jobs that require repetitive wrist movements or strong gripping.
Cases have also risen because of excessive use of laptops and mobile phones. Symptoms can be severe enough to cause sufferers to lose sleep, as well as hindering them in work and even the most basic daily tasks. In extreme cases, muscle in the hand and wrist can even waste away from under-use and, without treatment, CTS can result in irreversible nerve damage and loss of hand function.
Currently, the surgery offered on the NHS involves an invasive operation to open up the wrist to sever the carpel tunnel ligament.
Cutting the ligament does not impact the mobility of the hand. Patients rarely experience any pain and have full use of their hand as it heals. Research shows that, in most cases, CTS does not return even after the ligament has fully regrown. However, since the procedure involves cutting through layers of fat and muscle to get to the ligament, patients are left with a deep skin wound which can take months to heal.
But the new op is guided by an ultrasound scan which is held over the wrist. This allows the surgeon to see inside the wrist and avoids the need to open it up.
An incision is made at the base of the wrist and a small needle is threaded down to reach the carpal tunnel ligament at the point where it is pressing on the nerve. The needle is then used to cut the ligament, releasing the nerve, and then removed. The ultrasound scan ensures that the surgeon does not accidentally damage surrounding nerves and blood vessels.
The procedure is carried out under local anaesthetic and patients can leave the clinic the same day.
Cases of the condition have also increased due to the excessive use of mobile phones and laptops (file photo)
The only sign of the op is some bruising and a small scar, which experts say usually disappears.
Catherine Nolan, 44, discovered the new treatment after exhausting all other options. The Edinburgh-based painter and decorator first noticed pain in both her wrists 18 months ago.
She was diagnosed with CTS and given a splint to support her wrist. But the pain worsened, leaving her struggling with simple tasks such as removing the top of a bottle. She got steroid injections, but these only provided temporary relief.
‘It got so bad that I had to take two months off work – it felt like I was losing control of my hands,’ she says.
Catherine read about the ultrasound-guided procedure – and signed up for the operation. It was carried out on both her hands.
‘There wasn’t any discomfort and it took about an hour and a half,’ she says. ‘The next day, I took the bandages off and could already do basic things like make a cup of tea.
‘I went back to work two days later with a little discomfort but nothing that felt worse than a bruise. Within a week or two I was feeling better and it’s been smooth sailing since.
‘This operation has been completely life-changing.’
