Vim & Vigor - Winter 2019 - UVA - 52

Treating the Tingle
Surgery puts an end
to severe symptoms
of carpal tunnel
BY HOLLY FORD

rying her hair, putting on
socks, driving a car-like
many of us, Scottie Frey
took for granted her ability to complete these simple everyday
tasks. Until gradually, her hands just
wouldn't cooperate.
"My hands would fall asleep and tingle while I was drying my hair or driving, so I had to stop to rest more and
more as time went on," says 48-year-old
Frey, administrator of health information services at UVA Health. "I would
wake up in the middle of the night
because my hands would ache so badly.
Eventually I couldn't even put on my
socks. The symptoms got progressively
worse. But you just get used to it and
you find ways to work around the pain."
Fortunately, Frey's primary care
provider persuaded her not to ignore
her symptoms any longer. "My doctor
sent me to do a nerve study at the UVA
Electrodiagnostic Lab," Frey says, "and
they found that I had severe carpal tunnel in both hands."

Carpal Tunnel Defined

Carpal tunnel syndrome occurs when
the median nerve, which runs from the
forearm to the hand, gets squeezed as
it passes through the carpal tunnel, a
narrow passageway on the palm side of
the wrist. "The carpal tunnel can get
smaller for a variety of reasons and put

W IN TER 2 0 1 9

pressure on the nerve," says UVA orthopedic surgeon Angelo Dacus, MD. Some
of the most common causes of carpal
tunnel include:

Overuse and repetitive hand
motions, which thicken the ligament
covering the carpal tunnel.

Inflammation or swelling
around the tendon due to hormonal
changes during pregnancy or other
hormonal conditions.

Repeated and prolonged
positioning of the wrist.
Wrist injury or trauma, which
leads to swelling.
Carpal tunnel typically affects older
adults, but Dr. Dacus says he has treated
people as young as 20. "Carpal tunnel
is one of the most common conditions
we see at UVA Hand Center," he says,
"and there's not one particular cause or
one single demographic it impacts more
than others."

Carpal Tunnel Symptoms

Frey experienced some of the most
common carpal tunnel symptoms: pain,
tingling, weakness and numbness in
the hands, especially along the thumb,
index and long finger. Sometimes a
wrist splint or steroid injections can
help relieve symptoms. But for Frey,
whose carpal tunnel was more severe,
Dr. Dacus believed that surgery was
the best option. What was less certain
for Frey was how best to treat not one,
but two hands, both of which were
extremely symptomatic.
"Dr. Dacus gave me a choice," Frey
says. "I could do surgery in one hand
and get injections in the other to buy

time and relieve symptoms until I was
ready for surgery number two. Or I
could have both surgeries done at the
same time. I decided I didn't want to
have surgery twice."
"Patients who choose bilateral surgery are limited in what they can do;
they need a lot of help after surgery,"
Dr. Dacus says. "But if someone has
that support system in place, then
doing both hands at once can be a good
option, because symptoms are relieved
sooner in both hands, you're back at
work in one-and-a-half months instead
of three, and it's better financially."

Finding Relief

Carpal tunnel release surgery involves
making a small cut in the wrist,
then cutting the ligament that covers the carpal tunnel and opening up
that space to give the nerve room to
breathe, Dr. Dacus explains. "This is
the most common hand surgery and
has an 80 to 90 percent success rate-
about as good as it gets with a surgery,"
he says.
Frey came through surgery without
a hitch. "The surgery was scheduled
for 4 p.m., and I was home by 5 p.m.,"
she says. "My mom, adult daughter, son
and husband all helped me during my
recovery. It was tough, but within 48 to
72 hours, you can begin to do things on
your own. I was soon back at work, and
in two weeks, I was crocheting again."
Dr. Dacus says, "Typically, patients
are back to normal within six weeks,
and some may require physical therapy
to regain grip strength. But Scottie is a
very positive person and very motivated.
Those kinds of patients are going to
have the best outcomes." ■

Vim & Vigor - Winter 2019 - UVA

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