Carpal Tunnel Release

What is carpal tunnel release?

Carpal tunnel release is a surgical procedure used to treat carpal tunnel syndrome (CTS), a condition that causes pain, numbness, and tingling in your hand and fingers. CTS happens when your median nerve is compressed as it passes through the carpal tunnel, a narrow passageway in your wrist. This surgery relieves pressure on the median nerve by cutting the ligament that forms the roof of the carpal tunnel.

Why is carpal tunnel release performed?

Carpal tunnel release is recommended when non-surgical treatments, such as wrist splinting or corticosteroid injections, haven’t relieved your symptoms, or if the condition is severe. CTS can lead to persistent pain, weakness, or loss of hand function if left untreated. Surgery is generally advised when:

• Symptoms are affecting your daily activities or quality of life.
• Numbness or weakness in your hand is getting worse.
• Nerve damage is suspected, or muscle wasting in your hand is present.
• Non-surgical treatments haven’t provided lasting relief.

Carpal tunnel release is the most effective way to achieve long-term relief from CTS symptoms, especially when performed early, before permanent nerve damage occurs.

Preparing for carpal tunnel release

Before surgery, you’ll meet with a hand surgeon to assess the severity of your condition. Tests like nerve conduction studies or electromyography (EMG) might be done to confirm the diagnosis and evaluate any nerve damage. During your consultation, the surgeon will explain the procedure, risks, and recovery process.

You may be asked to stop taking certain medications, such as blood thinners, a few days before surgery to reduce the risk of bleeding.

What does the procedure involve?

This surgery is usually performed as a day-case procedure, meaning you can go home the same day. It’s typically done under local anaesthetic, so you’ll be awake, but your wrist and hand will be numbed. There are two main types of carpal tunnel release:

• Open carpal tunnel release: A small incision is made in your palm, and the surgeon cuts the ligament to relieve pressure on the median nerve.
• Endoscopic carpal tunnel release: A smaller incision is made, and the surgeon uses a camera (endoscope) to guide the procedure.

Both methods are effective, and the choice depends on your surgeon’s preference and your condition. The procedure usually takes 20 to 30 minutes.

What are the potential risks and complications?

Carpal tunnel release is a safe and routine procedure, but like any surgery, there are potential risks. These include:

• Infection at the surgical site.
• Scar tenderness or thickening.
• Stiffness or reduced movement in your wrist.
• Nerve injury (rare).
• Persistent symptoms or incomplete relief of CTS.
• Recurrence of CTS (rare).

Your surgeon will discuss these risks with you before the procedure and provide advice on how to manage them during recovery.

After the operation

After surgery, your wrist may be bandaged, and you’ll be advised to keep your hand elevated for the first few days to reduce swelling. Mild pain, bruising, and stiffness in your hand are common but can be managed with over-the-counter pain relief. Most people experience immediate relief from numbness and tingling, though full recovery of hand strength may take a few months.

You’ll likely be able to move your fingers soon after surgery to maintain flexibility, but you should avoid heavy lifting or strenuous activities for a few weeks. Physiotherapy exercises may help restore strength and range of motion in your hand.

Depending on your job and activity level, you can usually return to work and normal activities within 2 to 6 weeks. Following your surgeon’s advice on post-operative care is important to ensure the best recovery outcome.

Long-term outcomes

Carpal tunnel release surgery is highly effective, and most people notice significant relief from symptoms and better hand function. While full recovery can take a few months, many regain normal hand strength and return to their usual activities during this time.

However, if surgery is delayed, there is a chance that full recovery may not be possible, especially if permanent nerve damage has already occurred. Getting an early diagnosis and treatment for carpal tunnel syndrome is essential to achieve the best possible results.