Carpal tunnel surgery: what to expect

Written by: Ms Anna Moon
Edited by: Nicholas Howley

Those who experience carpal tunnel syndrome can suffer from intense pain in the hands, numbness, and even difficulty with gripping things. The good news is that carpal tunnel surgery is one of the fastest and most effective procedures a hand surgeon performs. We spoke to Ms Anna Moon, consultant orthopaedic hand surgeon at Spire South Bank Hospital, to find out what patients can expect from this treatment.

What is carpal tunnel surgery?

Carpal tunnel surgery is a simple procedure to release the transverse carpal ligament at the carpal tunnel, releasing the pressure on the median nerve.

Carpal tunnel surgery is one of the most common and efficient hand procedures on offer. The procedure itself takes just 10 minutes, and taking into account preparations such as the delivery of local anaesthetic, you’ll be in and out of the operating theatre within half an hour. Preparation is minimal – the only thing you might need to do is to stop taking blood thinning medication prior to the operation.

There are two main types of carpal tunnel surgery:

  • Open carpal tunnel release – this involves making a small cut in your palm. It is the most common form of surgery.
  • Endoscopic carpal tunnel release – this involves a slightly smaller incision but may carry greater risk of complications and longer to perform.

Whichever type of surgery is performed, the procedure should give you immediate pain relief.

What happens after the operation?

After the operation, stitches remain in the wound for about 10-14 days. During this time you should keep your hands elevated and keep your fingers moving.

How quickly will my symptoms improve?

  • Pain goes first, almost immediately after surgery, followed by pins and needles, then numbness you had.
  • It can take up to 6 months for nerves to fully recover and numbness to go. The nerve may never fully recover if it has been severely compressed for long time.
  • The strength in your hand will continue to improve for about a year

Muscle wasting, however, is permanent, and it will not recover. This is why it’s important to get a diagnosis and treatment early on.

When can I drive?

Wait 3-4 days for the wound to settle, then you can start driving as soon as you feel you have full control over the steering wheel.

You’ll need to notify your car insurance company that you had the procedure done and still have stitches in place. In any case, the stitches are generally removed within two weeks.

Complications from surgery

Carpal tunnel surgery is a very safe procedure.

The most common complications include:

  • Small risk of infection – between 0.2-0.4%
  • A very small risk of nerve injury – very rare
  • Sensitive scar - massaging the scar with moisturising cream or bio oils helps
  • Pillar pain – a hand therapist could help you with that
  • Persistent numbness - if the nerve does not fully recover during the six months post-surgery you may be left with a numbness at the tip of your fingers

Can carpal tunnel syndrome come back?

It is possible for carpal tunnel syndrome to reoccur, but it´s not common.

If you get signs and symptoms of carpal tunnel syndrome again it´s important to exclude other conditions which may give you the same or similar symptoms.

However, in some cases recurrence can happen because the release wasn´t fully done, or because there´s so much scar tissue that compression can occur again.

If you’re worried you might have carpal tunnel syndrome, or you’d like to talk about your treatment options, book a consultation with Ms Moon today.

By Ms Anna Moon
Orthopaedic surgery

Ms Anna Moon is a highly experienced consultant orthopaedic hand surgeon based in Worcester, Birmingham and Droitwich. She has been a consultant for seventeen years, treating various hand, wrist and elbow conditions such as nerve compression (carpal tunnel syndrome and cubital tunnel syndrome), Dupuytren’s contracture, ganglion cyst, trigger finger, tennis elbow, arthritis (rheumatoid and osteoarthritis), tendonitis and small joint replacement amongst others.

Most of the procedures are done under local anaesthetic using a technique called WALANT (wide awake local anaesthetic no tourniquet) or peripheral nerve block with or without sedation. Ms Moon works with top hand therapists who provide conservative treatment for wide range of conditions and facilitate fast postoperative recovery. She worked as a consultant in the NHS for eleven years, establishing and providing a hand trauma service in the catchment area of Worcestershire and Warwickshire as well providing elective care for patients with hand, wrist and elbow conditions. She is a strong believer in a patient-centred approach, tailoring treatment to each individual case and putting the patient's needs and requirements first.

Ms Moon is highly trained and highly qualified, holding a PhD (her thesis was on microsurgical techniques). She underwent extensive training in hand surgery and microsurgery across Europe. Ms Moon spent nearly two years in Abu Dhabi (United Arab Emirates) working with plastic surgeons on complex hand injuries. She was recently made visiting senior lecturer at Aston University and has been active in presenting and running courses at both a national and international level.

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