What to expect from carpal tunnel surgery

We talk to the experts to answer your big questions

06 January 2023 6 minute read

A doctor discussing carpal tunnel surgery with an elderly patient at the clinic

If you’ve been told that you need carpal tunnel surgery, it’s likely you have a fair few questions, from what happens during the procedure to how long it will take to recover. At nib, we consider ourselves your health partner. Here to help when it comes to understanding the complexities of navigating the hospital system as well as breaking down what might be involved in treatment and recovery. And while your healthcare provider is always the best person to provide you personalised information, we’ve answered some of the biggest questions you might have about what to expect from carpal tunnel surgery.

What is carpal tunnel syndrome?
What are the symptoms of carpal tunnel syndrome?
What are the causes of carpal tunnel syndrome?
What is carpal tunnel surgery?
What are the benefits of carpal tunnel surgery?
What other choices do I have other than surgery?
How can I prepare for carpal tunnel surgery?
Are there any complications from carpal tunnel surgery?
Recovery after carpal tunnel surgery

What is carpal tunnel syndrome?

Carpal tunnel syndrome is a painful disorder that occurs when there is increased pressure on the median nerve, which is the nerve that crosses the front of your wrist and passes down the front of the hand. Those suffering from carpal tunnel syndrome typically experience pins and needles, numbness and weakening in different parts of the hand.

What are the symptoms of carpal tunnel syndrome?

The symptoms of carpal tunnel syndrome vary from mild to severe, and typically include:

Pain of the hand, especially at night
Pins and needles
A burning sensation
Numbness
Swelling
Weakness of the hand
Radiating pain into the arm and/or shoulder

What are the causes of carpal tunnel syndrome?

In some instances, it’s not possible to pinpoint the cause of carpal tunnel syndrome. In other cases, it’s caused by a combination of different factors including:

Inflammation
Arthritis
Pregnancy
Obesity
Diabetes
Growth abnormalities
A tumour
An injury due to overuse
Wrist fractures

What is carpal tunnel surgery?

Carpal tunnel surgery (also known as carpal tunnel release surgery) is a procedure performed when there is significant symptoms of carpal tunnel syndrome. The surgery is a day procedure.

Surgery is typically recommended when nonsurgical treatments (like rest, physiotherapy or wearing a splint) have not improved the symptoms and the resulting pain or discomfort is interfering with daily activities. It can also be needed when a tumour is the cause of pressure on the median nerve.

During carpal tunnel surgery, an incision will be made in your wrist, followed by a small cut through the transverse carpal ligament, which runs across the wrist. This releases pressure on the median nerve. Once this occurs, the incision is sewn closed.

The two main carpal tunnel surgeries are open surgery or keyhole surgery

There are two main approaches for the surgery:

1
Open carpal tunnel release surgery – An incision of 1-5 cm is made at the wrist, the ligament is cut and the skin is closed with stitches.
2
Keyhole carpal tunnel release surgery – With keyhole entry, a smaller incision is made at the palm and/or wrist for an endoscope (flexible tube with a camera) to be passed through to produce real-time video onto a screen to make it easier for the surgeon to see and cut the ligament before closing the incision with stitches.

Either way, during the healing process, the body will rejoin the severed ligament, and the
resulting scar tissue should result in less pressure on the nerve over time.

What are the benefits of carpal tunnel surgery?

The benefits of carpal tunnel release surgery can be seen within the first 12 months. Benefits may include:

Improved hand sensation
Reduction in pain
Better sleep
Regained hand function
Improved muscle strength
Nerve decompression

What other choices do I have other than surgery?

Nonsurgical interventions can help with short-term relief of some symptoms of carpal tunnel syndrome. They are appropriate when carpal tunnel is not causing significant pain, range of motion is sufficient and the symptoms do not restrict daily activity.

Activity modification by reducing tasks causing symptoms can improve the condition slightly or avoid it worsening.

Other for carpal tunnel syndrome include:

Physical therapy exercises
Splinting
Anti-inflammatory medicine
Treating any underlying conditions
Changing your work duties

How can I prepare for carpal tunnel surgery?

1
Tell your doctor about any medications, vitamins, and/or supplements you’re currently taking. This includes prescription and over the counter medications
2
You may need to stop taking medications that can interfere with the blood’s ability to clot, such as ibuprofen or aspirin. We recommend seeking advice from your medical practitioner
3
Follow any instructions regarding fasting from eating or drinking. You will typically need to fast for at least six hours before the procedure
4
Arrange for someone to drive you to and from hospital

Are there any complications from carpal tunnel surgery?

Carpal tunnel surgical recovery usually has low incidence of complications. However, there
are occasions where certain complications may arise, and it is important to know what these are.

These include stiffness on the affected hand, pain from the incision, excess scar tissue and sometimes bleeding. In rare cases, the wound may open slightly, and this could lead to infection if left unattended.

After the surgery you may experience weakness in your grip strength. The recurrence of carpal tunnel syndrome ranges from three to 25%.

Recovery after carpal tunnel surgery

Your healthcare provider will provide information about what you should and shouldn’t do during your recovery period. As a general guide, here are a few tips to help you recover after your surgery:

To prevent swelling, place cold packs over your wrist for 10 to 20 minutes at a time
Keep the dressing of the wound dry
Relieve pain by taking paracetamol and/or ibuprofen. Your doctor might order additional pain relief medication for you if you require so
protect and brace your hand with a splint for approximately 2 weeks
Avoid leaving your hand hanging, as this may cause swelling (keep it upright or in a
sling)
Prevent strains by avoiding lifting anything heavier than 500g for up to two weeks
after surgery
Avoid swimming and other hand-intensive activities for four weeks
Keep hydrated with ice and fluid and eat a nutritious diet

Are you heading to hospital soon?

If you’re with nib, make sure you check out our Going to Hospital page page. This tool gives you information on health insurance, tips on how to reduce any out-of-pocket expenses and helpful questions to ask your specialist. To find out the details of your current policy, chat to someone about an upcoming hospital visit or get some guidance, please call us on 13 16 42.

Please note: The tips throughout this article serve as broad information and should not replace any advice you have been given by your medical practitioner.