What Is Carpal Tunnel Surgery?

Carpal tunnel surgery is an operation that becomes necessary if the transverse carpal ligament in the hand starts to press on the median nerve, the main nerve that passes from the arm through the wrist and into the hand. This happens to many people as they get older, and the result is mild tingling, pins and needles, and numbness in the hands and fingers.

As the ligament continues to press on the nerve, it can start to cause damage, and this results in more numbness, pain and aching, and you can start to find it difficult to move your fingers. For people who play a musical instrument, or use a computer keyboard for work, this can be disastrous.

Carpal Tunnel Release

When the symptoms start to get worse, and if you have been experiencing tingling and numbness for at least six months with no improvement, your GP will probably refer you for carpal tunnel release surgery. This operation is fairly common and is designed to cut the carpal ligament and to prevent it from pressing on the nerve. Once you have recovered from the operation, any pain in your hand will go away almost immediately. The numbness and pins and needles then take several weeks or even months to resolve completely, as the nerve needs time to recover. Nerves cannot regenerate very well, but as long as the nerve has not been destroyed, you should find that your hand gets back to normal within about six months.

Tendon Surgery In The Hand

Carpal tunnel release surgery is usually done as a day case, and you will attend the hospital as an outpatient for the operation. You'll probably be required to arrive at the hospital very early in the morning for pre-surgery checks, and the procedure should take place in the morning. The surgery is usually carried out using a local anaesthetic rather a general anaesthetic, so you should be fine to eat and drink as usual. You will not be able to see what is going on but you will be fully aware, and it is rare for people to need sedation.

The surgery itself will take only about 10 to 20 minutes. You'll be asked to sit or lie down, then a tourniquet will be tied to your upper arm and you'll receive a local anaesthetic injection. The operation involves cutting into the skin to gain access to the wrist, then cutting the ligament before the cut is stitched up. Some surgeons prefer to do open surgery, while others use a keyhole technique that makes smaller incisions. The advantage is that healing times for the skin are quicker with the keyhole method.

After Carpal Tunnel Surgery

Once you have had the operation you will need to rest to make sure that your wound doesn't bleed and that you feel OK as the local anaesthetic starts to wear off. Obviously, you won't be able to drive home, so you need to arrange for someone to accompany you to the hospital and take you home afterwards. Your wrist will be put into a splint to keep it immobilised, and you will probably also have a sling.

You should keep the splint on for the first few days, and you will be given exercises to increase the movement in your hand and fingers. It will be fine to take normal painkillers to relieve any pain or aching in the first couple of days, but after that, your hand and wrist should start to feel better quite quickly. The operation to relieve carpal tunnel syndrome is very successful in most people.

You may get some advice on how to protect your other wrist from developing the same condition. If you do work on a computer most of the time, posture can be very important and having had surgery on one wrist, most people are only too keen to make some changes to their workstation to avoid the problem in their other arm.