Carpal tunnel surgery

Carpal tunnel syndrome is a condition where there's pressure on the nerve that controls sensation and movement in your wrist and hand. Before it reaches the thumb and fingers, this nerve (the median nerve) passes through the carpal tunnel. This is a space located in the wrist and sits between the bones and a thick fibrous ligament.

Pressure in the carpal tunnel on the median nerve can be due to a variety of factors. It can be difficult to pinpoint one specific cause. When pressure develops, it can lead to symptoms in the fingers, thumb, wrist and sometimes the arm or shoulder.

What causes carpal tunnel syndrome?

There is often no clear cause for carpal tunnel syndrome, but there are some risk factors which might increase the chances of someone developing the condition. These include: 

• Inflammation caused by repetitive movements in the hand or wrist or degenerative conditions such as rheumatoid arthritis. Carpal tunnel syndrome can also appear in pregnancy due to hormone changes that result in inflammation or swelling. 
• A narrow carpal tunnel, which is more commonly seen in women. 
• Previous hand or wrist injuries can sometimes increase the pressure in the median nerve that's responsible for the condition.. 
• Type 2 diabetes or thyroid problems can increase the risk.

When should I see a doctor about my carpal tunnel syndrome?

Seeking advice before symptoms become severe can mean you receive treatment before the tingling, pain or numbness start to affect your ability to carry out everyday activities. It would also prevent the longer-term nerve damage that can occur if left too late.

What are the treatments for carpal tunnel syndrome? 

To provide relief from carpal tunnel symptoms, your doctor might suggest you try non-surgical treatment methods to begin with. These could include: 

• A splint for night-time: This helps to prevent wrist movement and reduces nerve compression.
• Steroid injections: Cortisone is an anti-inflammatory that is injected directly into the carpal tunnel and can offer symptom relief for a few months or longer term. 

If non-surgical treatments fail, or symptoms are severe, then carpal tunnel surgery (or carpal tunnel release) might be recommended. Surgery usually removes the symptoms completely and improves quality of life.

What is a carpal tunnel release surgery?

This treatment involves a day case operation to release the pressure on the carpal tunnel and relieve the symptoms. You won’t be required to stay overnight. The operation is usually under local anaesthetic which means you won't need to be put to sleep when undergoing this type of surgery.

Carpal tunnel release surgery involves the surgeon making a small incision on your palm to carefully open the roof of the carpal tunnel. This removes the pressure on the nerve. The skin wound will then be stitched back up and, after the recovery period, you can expect to experience good relief from your symptoms.

What are the benefits of carpal tunnel surgery? 

The main benefits of having surgery to treat carpal tunnel syndrome include a significant reduction in tingling, pain and numbness. You may sleep better at night without the symptoms and you may find it much easier to use your hand for everyday tasks. 

Carpal tunnel surgery aims to offer permanent relief from the symptoms of the condition once the initial recovery period has taken place. 

Are there any risks associated with carpal tunnel surgery?

Carpal tunnel release surgery is safe and the risks are low compared to other operations. However, your surgeon will discuss any potential complications with you before surgery. These might include: 

• Infection or bleeding associated with the wound
• Damage to nerves resulting in temporary pain and numbness

If any problems persist, you may be referred for physiotherapy treatments or even further surgery if symptoms fail to improve.

Full recovery from surgery can take a few weeks to a few months. The length of time depends on the severity of the condition prior to the procedure and how long you initially had symptoms for.