Carpal Tunnel Release Surgery

This image and more information about carpel tunnel syndrome/the release procedure can be found at hopkinsmedicine.org.

The Surgery

The surgeon will release the median nerve from beneath the transverse carpal ligament. This will allow the nerve to heal and will relieve your symptoms of discomfort. Full range of motion of the wrist and fingers is normally the case and you can expect this in the first four to six weeks after surgery. In six to eight weeks you will have your pinch strength back, and in twelve to twenty-four weeks your normal grip strength will return.

Image from medlineplus.gov showing an open carpel tunnel release procedure.
Image from www.hopkinsmedicine.org showing a carpal tunnel release performed endoscopically.

Possible Complications

Less than ideal results are usually related to ongoing scar sensitivity, persistent numbness and pain, loss of endurance during gripping, and weakness. Following your surgeon’s and therapist’s advice in all aspects of recovery reduces the likelihood of having a less than satisfactory outcome.

Carpal Tunnel Release FAQ

How long does the surgery take?

Release of the tissue (transverse carpal ligament) that compresses on the median nerve will take the surgeon approximately twenty minutes. You will leave the hospital with a bulky dressing on your wrist.

Will all my pain and numbness go away immediately after surgery?

It may, or it may progressively improve in the days and weeks following surgery. This depends on a number of factors, including:

  1. How long you have had symptoms before surgery.
  2. How severe you symptoms were.
  3. Your overall health and any other hand conditions (e.g., arthritis).

Do I need hand therapy after my surgery?

Your surgeon will usually recommend you attend hand therapy within one to three days of your carpal tunnel release surgery.

Your hand therapist (either occupational or physiotherapist) will guide you through the post-operative stages. This may take eight to ten weeks. The goals of therapy will include:

  • Education on Wound Care
  • Hand Use
  • Splinting
  • Scar Management
  • Strengthening
  • Returning to Work
  • Achieving the Best Possible Overall Outcome from Surgery

Will I have pain after surgery?

Your surgeon will apply a “block” to your hand so that you have prolonged pain relief for days after surgery.

Image from www.acep.org showing a block being administered to the median nerve at the wrist.

The incision is about the length of your pinky finger over your palm. This wound usually heals well with light dressings. Very infrequently, you may have excessive swelling which may open the incision and require more attention. In general, there is very little discomfort from the surgery and infection rates are low.

When can I go back to my usual activities?

Your surgeon will have you take anywhere from six to eight weeks off from heavier types of work; light work is okay. Gradually returning to daily light activities such as eating, light lifting (up to one pound), dressing, and self-care are allowed in the first three weeks. Your hand therapist can advise you with what tasks to avoid (e.g., raking, writing, excessive typing, strenuous gripping, cold environments, etc.).

What is hand therapy?

Hand therapy is the art and science of rehabilitating the upper limb, which includes the hand, wrist, elbow, and shoulder girdle. Using specialized skills in assessment, planning, and treatment, hand therapists provide exercises, wound care and education.

For More Information Visit:

http://www.mayoclinic.org/diseases-conditions/carpal-tunnel-syndrome

Canadian Society of Hand Therapists: http://www.csht.org.