Carpal Tunnel release

Carpal tunnel syndrome is a common condition that occurs when there is too much pressure on a nerve in the wrist. This debilitating condition may result in pain, numbness or tingling of the thumb, fingers and sometimes part of the hand. It is most common in patients who perform repetitive tasks with the hand and wrist such as computer keyboard and mouse use. One or both hands can be affected and symptoms can be worse at night, disturbing sleep.

When symptoms last for more than six months or other treatments have not been effective, carpal tunnel release surgery may be recommended.

What happens?

Carpal tunnel release surgery is performed on an outpatient basis, which means you will not have to stay in hospital overnight. During surgery the roof of the carpal tunnel, known as the carpal ligament, is cut to reduce pressure on the median nerve in the wrist. A local anaesthetic is used to numb your hand and wrist, but you will remain awake throughout the operation.

The surgery can be performed as open surgery, which involves making a single cut in the wrist, and is the traditional type of operation. Some surgeons use keyhole surgery, where special instruments and a long tube with a light at one end and an eyepiece at the other are inserted through small cuts in your wrist, and sometimes your palm. This allows the surgeon to see the carpal ligament on a monitor throughout the operation.

Keyhole surgery usually has a slightly quicker recovery time than open surgery and may cause less scarring and tenderness. There are no long-term differences in the outcomes of the two approaches. Your surgeon will be able to discuss the most appropriate method of surgery with you.

Following carpal tunnel release surgery, your hand will remain in a bandage for a couple of days and you may need to wear a sling. You should keep your hand raised for 48 hours to help reduce any swelling and stiffness in your fingers. To help prevent stiffness, gently exercise your fingers, shoulder and elbow. You may be able to start these gentle exercises on the day of your operation.

Are there any risks?

As with all surgery, there are risks involved. General risks from any surgery can include pain, bleeding, infection and/or scarring. Your consultant will talk you through them.

Specific complications related to carpal tunnel release surgery can include:

• Continued numbness in fingers
• Tenderness around scar
• Aching in the wrist
• Return of numbness and pain
• Complex regional pain syndrome – a rare, but chronic (long-term) condition that causes a burning pain in one of the limbs

Ask your surgeon to explain in more detail how any risks apply to you.