Home > Procedures > Peripheral Nerve Surgery > Carpal Tunnel Surgery

Carpal tunnel surgery is performed to treat carpal tunnel syndrome, also known as median nerve compression. This a painful medical condition that causes numbness, tingling, or weakness in the affected hand.

Carpal tunnel syndrome is a congenital predisposition. Injuries like fracture or sprain, or even overusing a vibrating tool can cause this condition. In some studies, it is found to be associated with diabetes, pregnancy, rheumatoid arthritis, and thyroid disease. 

Once the diagnosis is confirmed with nerve conduction studies, surgery is performed to relieve the symptoms and signs of carpal tunnel syndrome. Patients with mild symptoms of carpal tunnel syndrome can try non-surgical treatment options before carpal tunnel surgery. Such management options may be physical therapy, over-the-counter pain medications, alterations to some of the equipment used at the workplace, shots of steroids in the wrist, or wrist splints to help alleviate pain and swelling. 

Following are some of the factors that indicate to undergo a carpal tunnel surgery:

  • No relief from nonsurgical treatment options
  • Weak muscles of the wrists or hands and getting reduced in size due to the severe pinching of the median nerve.
  • If the diagnosis comes out to be carpal tunnel syndrome after an electromyography test of the median nerve
  • The symptoms have lasted more than 6 months without any relief

How is carpal tunnel surgery performed?

Carpal tunnel release surgery is generally performed in an outpatient setting. This means the patient can go back home the same day. The procedure is usually done under a local anaesthetic.

There are two types of carpal tunnel surgery:

Open surgery 

This is a well established technique where a small incision is made on the palm and the transverse carpal ligament is divided to release the median nerve . This surgery is done under magnification by using surgical loupes.

open carpal tunnel release
Picture credit: The Jon Hopkins University

Endoscopic carpal tunnel or Minimally invasive surgery

In this procedure, the surgeon makes 2 half-inch incisions on the patient’s wrist. From one incision, a flexible, thin tube containing a camera is put into the patient’s wrist. The camera assists the treating surgeon as the carpal tunnel surgery is performed with the help of thin instruments put into the patient’s wrist through the other tiny incision.

endoscopic carpal tunnel release
Picture Credit: The Johns Hopkins University

After treating the affected area, the surgeon closes the incisions with sutures. The hand and wrist of the patient will be bandaged or placed in a splint to restrict any movements. The patient will be kept under observation for a short time after the surgery, and then is allowed to go back home. Only in some complications or rare scenarios will the patient need overnight hospitalisation after carpal tunnel surgery.

What are the risks and possible complications with this procedure?

With any surgery there are generally associated risks and complications. The following are some of the risks related to carpal tunnel syndrome:

  • Damage to the median nerve or adjacent blood vessels and nerves
  • Bleeding
  • Infection at the treatment site
  • Tender scar

How long does carpal tunnel surgery take to heal?

The recovery period after carpal tunnel surgery is usually a few weeks. The recovery period may take longer if the median nerve has been compressed for a long time. The recovery process includes splinting the patient’s wrist and later getting physical therapy. Starting after at least one week, physical therapy helps to heal and strengthen the hands and wrists.

After the carpal tunnel surgery, the patient should take care of the following:

  • Keep the hand elevated above the heart
  • Keep moving the fingers to prevent stiffness and to alleviate swelling
  • Apply an ice pack a few times a day for a given amount of time
  • Wear a wrist brace or a splint for several weeks 

Is carpal tunnel surgery successful?

Carpal tunnel surgery has a very high success rate of more than 90%. Most of the symptoms such as waking up at night, discomfort, and tingling sensation in the hands are quickly relieved post-treatment. It may take around 3 months for the numbness to get better.

The extent of recovery of power and sensation will also depend of the duration and severity of symptoms.

Frequently asked questions

Should I wear a wrist brace after carpal tunnel surgery?

It is advised to wear a wrist brace or a splint for few weeks post-carpal tunnel surgery.

Can carpal tunnel be fixed without surgery?

Yes, in the early stages of symptoms, carpal tunnel syndrome can be fixed without surgery. Non surgical management includes avoiding precipitating factors, use of hand splints, hand physiotherapy and trial of steroid injection. 

Can you get carpal tunnel again after surgery?

The recurrence of carpal tunnel symptoms even after the surgery is possible due to scarring . The recurrence rate varies from 3% to 25%. The results after the second surgery are variable with reports demonstrating persistent symptoms in up to 95% of the patients.

Can you use your hand immediately after carpal tunnel surgery?

No, the hand and wrist of the patient will be bandaged heavily or placed in a splint to restrict any movements. 

How long does carpal tunnel release surgery take?

The procedure takes around 15 minutes to complete.

How much time off work for carpal tunnel surgery?

If a patient undergoes surgery on the dominant hand and does repeated movements at work, then the patient may be able to return to work in 2-3 weeks. Repeated actions such as typing or using heavy machinery are best avoided in the initial return to work. 

How soon can you drive after carpal tunnel surgery?

Most patients can drive two weeks after surgery. 

What kind of doctor performs carpal tunnel surgery?

Carpal tunnel surgery is commonly performed by a trained neurosurgeon, plastic surgeon or orthopaedic hand surgeon. 

Are you awake for carpal tunnel surgery?

Carpal tunnel surgery can be easily done under the effect of local anaesthesia. This means the patient is awake and only the area being treated is numbed.

It can however be done under a short general anaesthetic if the patient is very anxious or prefers not to be awake during surgery.