Carpal tunnel surgery

The carpal tunnel is a narrow passage at the front of the wrist. The median nerve, which provides feeling to the thumb, index and middle fingers, runs through it with the finger tendons. When the tunnel becomes too tight, the nerve is compressed: tingling, numbness and pain, often at night, followed by clumsiness and weakness of the hand. The operation consists of cutting the ligament that forms the "roof" of the tunnel to give the nerve more room. It is done through a small incision in the palm or, in some cases, endoscopically through an even shorter incision. The ligament then heals in a wider position. Surgery is offered when symptoms persist despite a night splint or a steroid injection, or straight away when the electromyogram (nerve test) shows significant nerve damage. The earlier the nerve is released, the better the recovery. At Clinique Pasteur Tunis, the electromyogram can be carried out in the neurophysiology department, and the operation is done as a day case under local anaesthesia or a nerve block of the arm.