Carpal tunnel release surgery

What is carpal tunnel release surgery?

Carpal tunnel release surgery, also known as carpal tunnel decompression or carpal tunnel surgery, is a highly effective procedure that relieves pressure on the median nerve as it passes through a narrow passage in the wrist called the carpal tunnel. When this nerve is compressed, it can cause pain, tingling, numbness, and weakness in the hand and fingers, a condition known as Carpal Tunnel Syndrome (CTS).

The surgery works by cutting the flexor retinaculum, the ligament that forms the roof of the carpal tunnel. This creates more space for the nerve and tendons, easing pressure and reducing symptoms. Carpal tunnel release surgery often provides long-term symptom relief, especially when conventional treatments haven’t helped.

What causes carpal tunnel syndrome?

Common causes of carpal tunnel syndrome include:

• Repetitive hand or wrist movements
• Wrist injuries
• Pregnancy-related swelling
• Arthritis
• Diabetes
• Thyroid conditions
• Genetic predisposition.

What are the symptoms?

Symptoms can typically include:

• Tingling or “pins and needles”
• Numbness in the thumb, index and middle fingers
• Weak grip or dropping objects
• Pain radiating up the arm
• Symptoms that worsen at night.

Who is most at risk?

Carpal tunnel syndrome is more common in:

• Women than men
• People aged 40 years and over
• Those with repetitive manual jobs
• People with diabetes or thyroid disease
• Pregnant individuals.

Can carpal tunnel syndrome go away on its own?

Mild symptoms may improve with rest, splinting or activity changes. However, persistent or worsening symptoms usually require treatment. Long-term compression can lead to permanent nerve damage if left untreated.

What happens if carpal tunnel syndrome is left untreated?

Untreated carpal tunnel syndrome can lead to:

• Permanent numbness
• Muscle wasting at the base of the thumb
• Reduced hand strength
• Difficulty performing everyday tasks.

Conditions often misdiagnosed as carpal tunnel syndrome

Two conditions commonly mistaken for carpal tunnel syndrome are:

• Cervical radiculopathy: Nerves that are compressed in the neck
• Ulnar nerve compression: Also known as cubital tunnel syndrome, affects the ring and little fingers.

What conditions does carpal tunnel release surgery treat?

Carpal tunnel release surgery is used to treat:

• Confirmed carpal tunnel syndrome
• Persistent symptoms despite splinting or steroid injections
• Nerve compression causing weakness or muscle loss
• Severe night-time symptoms
• Cases where nerve conduction studies show significant compression.

How do I know if I need carpal tunnel release surgery?

You may be recommended carpal tunnel release surgery if:

• Symptoms persist for more than 3 months
• Conservative treatments haven’t helped
• You have weakness or muscle wasting
• Nerve tests show moderate to severe compression
• Symptoms are affecting your daily life or sleep.

Who is suitable for carpal tunnel release surgery?

You may be suitable if you:

• Have confirmed carpal tunnel syndrome
• Have ongoing symptoms despite non-surgical treatment
• Are in good general health.

Who may not be suitable

Surgery may not be recommended if you:

• Have an active infection
• Have symptoms caused by another condition
• If local anaesthesia is unsuitable, you may be offered general anaesthesia
• Have mild symptoms that respond to splinting.

What are the alternatives to carpal tunnel release surgery?

Many people try non-surgical treatments first, including:

• Carpal tunnel splints (especially at night)
• Steroid injections
• Physiotherapy or nerve gliding exercises
• Making adjustments to certain activities
• Anti-inflammatory medication.

These can help in mild to moderate cases, but surgery is often recommended when symptoms persist.

How should I prepare for my carpal tunnel release surgery?

Your surgeon may advise you to:

• Stop certain medications if needed
• Arrange transport home
• Wear loose clothing and remove all rings, watches and other jewellery from the hand to be operated on
• Avoid heavy lifting before and after surgery
• Prepare for a short recovery period.

What happens at my pre-operative assessment?

Before surgery, you’ll attend a pre-operative appointment where your surgeon will:

• Review your medical history
• Carry out any necessary tests
• Discuss anaesthetic options
• Give you guidance on preparing for surgery.

What happens on the day of my carpal tunnel release surgery?

Carpal tunnel release is usually performed as a day case, meaning you can go home the same day. You’ll meet your surgical team, who will confirm your consent for the surgery and mark your wrist for accuracy.

What happens during carpal tunnel release surgery?

Carpal tunnel release is typically performed under local anaesthetic, so your hand is numb but you remain awake. Some patients receive light sedation to help them relax. The procedure usually takes around 20 minutes.

Your surgeon will:

1. Make a small incision in your palm or wrist
2. Gently expose the flexor retinaculum (tissue that forms the roof of the carpal tunnel)
3. Cut the ligament to relieve pressure on the median nerve
4. Close the incision with stitches
5. Apply a dressing or light bandage.

Open release, endoscopic release vs ultrasound-guided release - which is best?

Your surgeon will recommend the most suitable technique:

Open release

• Traditional method
• Small incision in the palm
• Excellent visibility of the ligament.

Endoscopic release

• Tiny incision
• Camera guided
• Potentially quicker recovery.

Ultrasound-guided release

• Minimally invasive
• Uses ultrasound to guide the procedure
• Quicker return to activities of daily living
• Not suitable for all patients.

My recovery after carpal tunnel release surgery?

Your recovery timeline can vary depending on the extent of your surgery.

Common experiences may include:

• Mild soreness
• Stiffness
• Swelling
• Tingling sensation as the nerve recovers.

Returning to daily activities

• Driving: Usually after 1–2 weeks
• Work:
  • Desk work: 1–2 weeks
  • Manual work: 4–6 weeks
• Exercise: Gentle movement only; avoid heavy lifting for 4–6 weeks.

You may go home with a splint or bulky bandage. Once removed, physiotherapy or hand exercises help restore movement and strength – these will be discussed with your consultant.

What are the possible complications of carpal tunnel release surgery?

Carpal tunnel release surgery can be very successful, with most people experiencing long-term relief. However, all surgery comes with some risks.

General risks can include:

• Pain
• Bleeding
• Infection
• Scarring.

Specific risks can include:

• Persistent numbness
• Tenderness around the scar
• Wrist aching
• Recurrence of symptoms
• Complex regional pain syndrome – a rare condition causing severe long-lasting pain and inflammation.

Will carpal tunnel syndrome come back?

Recurrence is uncommon, but possible. Most patients experience long-lasting improvement, with 70–90% of patients experiencing significant, lasting relief after carpal tunnel release surgery.

How much does carpal tunnel release surgery cost at Nuffield Health?

Select your local Nuffield Health hospital to find contact details and guide prices for carpal tunnel release. Please note that the stated guide price is only an approximate cost of the treatment. You will be given a fixed all-inclusive price for treatment following your initial consultation with a consultant.