If you're living with chronic hand or wrist pain, chances are you willfully want relief. Many times, non-surgical treatment is quite effective as a remedy for hand and wrist pain. However, there are circumstances in which hand surgery is the only long-term solution.
So when is it time to consider undergoing hand surgery for your carpal tunnel syndrome, rheumatoid arthritis, or other hand condition?
When Do I Need Carpal Tunnel Surgery?
You might be suffering from carpal tunnel syndrome if you have:
- Numbness or tingling in the thumb, index, middle, or half the ring finger
- Fingers fall sleep while driving, talking on the phone, washing hair, etc.
- Severe nighttime pain
- Pain radiating to forearms, shoulders, neck
- Dropping objects
- Objects falling out of hand
- Weak grip strength
Pain relief is the main purpose for performing most hand surgeries, including carpal tunnel release surgery. Individual pain thresholds vary, so some individuals let the condition progress further than others before they consider hand surgery. In most cases, carpal tunnel patients decide that hand surgery is necessary when they start experiencing numbness in the fingers, severe nighttime pain, and radiating hand pain.
There are three different surgical options to address carpal tunnel pain:
- Open Carpal Tunnel Release – traditional surgery with large incision, longer recovery period.
- Mini Carpal Tunnel Release – traditional open surgery with a smaller incision.
- Endoscopic Carpal Tunnel Release (Also known as The No Stitch Procedure) – minimally invasive, 10 minute procedure, no stitches required, short recovery period.
Can You Have Surgery for Rheumatoid Arthritis?
Rheumatoid arthritis has no known cure. This is a chronic inflammatory, autoimmune disorder, meaning the body's immune system mistakenly attacks its own tissues. Because of this, rheumatoid arthritis treatments mainly focus on controlling symptoms and preventing joint damage.
You may have rheumatoid arthritis if you are experiencing:
- Tender, warm, swollen joints
- Morning stiffness that can last for hours
- Rheumatoid nodules – firm bumps of tissue under the skin on the arms
- Fatigue, fever, weight loss
Since there is no absolute cure for rheumatoid arthritis of the hand, medications can reduce joint swelling, treat pain, and prevent or slow joint damage, but very little else.
The best treatment is to manage rheumatoid arthritis symptoms as best as possible from early on. Being proactive in this way will hopefully prevent or slow irreparable damage to your hands.
Unfortunately, many who suffer from hand and wrist arthritis do not take action until they feel significant pain and the damage has already begun. Severely damaged joints due to rheumatoid arthritis of the hand make hand surgery necessary.
If medications and other treatments fail to prevent joint damage from rheumatoid arthritis, there are several surgical procedures to consider:
- Total joint replacement – Damaged parts of joint are removed and replaced with a prosthesis made of metal or plastic
- Tendon repair – Surgical repair of the tendons around joints that may have loosened or ruptured
- Joint fusion – For when joint replacement is not an option; two joints may be fused together to stabilize or realign a joint, often resulting in pain relief
It is difficult to regain full function of the fingers after damage from rheumatoid arthritis, but significant improvement in function, pain, and appearance can be expected after this kind of hand surgery. Removal or repair of the arthritic areas will not remove the cause of the disease, meaning problems can return, which will require additional attention from your hand doctor.
Is There a Surgery to Remove Ganglion Cysts?
Ganglion cysts are very common and usually appear on the wrist. The cyst is a pocket of fluid that has built up on a weak spot of the ligament wall. Ganglion cysts are almost always benign, meaning they are non-cancerous.
In general, ganglion cysts do not cause pain or limit a person's range of motion. Of course, this is not always the case. In some individuals, cysts like these can become chronically painful and must be treated.
The least aggressive treatment for a ganglion cyst is rest. It is recommended for those who are not experiencing pain or discomfort from their cyst. A hand doctor will recommend immobilization of the cystic hand or wrist, either with or without a splint. Ganglion cysts can go away on their own, but only with time.
The next, more aggressive option is aspiration, which simply means draining the cyst of built-up fluid. A hand doctor, who will use a needle and syringe to draw out fluid contained in the cyst, performs this procedure using local anesthesia. Aspiration is a good temporary solution with little to no recovery time. However, the cyst is likely to reappear, as the “root,” or the sac, will always heal where it has been punctured and begin to fill up again gradually.
Surgical excision is the most thorough treatment option for getting rid of a ganglion cyst. Patients who resort to hand surgery usually do so because their ganglion cyst has become painful or uncomfortable. Close proximate to a nerve, for example, could cause a great deal of discomfort and pain, especially with range of motion.
Surgical excision, performed by a hand doctor, usually only takes about 20-30 minutes. This method has the least chance of the cyst re-forming. This is because the root, or the sac, trapping the fluid is completely removed so that it can not close and fill up again.
Ultimately, they are your hands and wrists, and you only get one pair, so take care of them! It may be easier to ignore pain when it first appears, but visiting a hand doctor right away for your condition could extremely save you from needing surgery to correct the damage.