Carpal tunnel release

You should get relief from pain and numbness in your hand. Any weakness should improve over time.

If your symptoms are mild, a wrist support worn at night often helps.

A steroid injection near the carpal tunnel can reduce the numbness or pain in most people but the symptoms usually come back after several weeks or months.

Symptoms may improve if there is an underlying cause that is treated. In those people with no underlying cause, symptoms usually continue but can get better or worse for no known reason.

If the compression of the nerve is severe and you do not have any treatment for a long time, the nerve may become permanently damaged. This makes some of the muscles at the base of your thumb waste away and you may get permanent numbness in your hand. A carpal tunnel release procedure at this stage may not be able to put right the damage already done.

The procedure can usually be performed under a local anaesthetic and usually takes about 20 minutes.

Your surgeon will make a small cut on the palm of your hand. They will cut the tight ligament (the flexor retinaculum) that forms the roof of the carpal tunnel. This stops the nerve being compressed.

If you smoke, stopping smoking now may reduce your risk of developing complications and will improve your long-term health.

Try to maintain a healthy weight. You have a higher risk of developing complications if you are overweight.

Regular exercise should help you prepare for the procedure, help you recover and improve your long-term health. Before you start exercising, ask the healthcare team or your GP for advice.

Speak to the healthcare team about any vaccinations you may need to reduce your risk of serious illness while you recover. When you come into hospital, practise hand washing and wear a face covering when asked.

The healthcare team are trained to reduce the risk of complications.

Any risk rates given are taken from studies of people who have had this procedure. Your doctor may be able to tell you if the risk of a complication is higher or lower for you.

Possible complications of this procedure are shown below. Some may be serious.

General complications of any procedure

• Bleeding during or after the procedure.
• Allergic reaction to the equipment, materials or medication.
• Infection of the surgical site (wound).
• Chest infection — your risk will be lower if you have stopped smoking and you are free of Covid-19 (coronavirus) symptoms for at least 7 weeks before the procedure.

Specific complications of this procedure

• Numbness in your thumb, index and middle fingers. This can be temporary or permanent.
• Tenderness of the scar. It can be a permanent problem.
• Aching in your wrist when using your hand.
• Return of numbness and pain caused by scar tissue that forms.
• Severe pain, stiffness and loss of use of your hand. Your hand can take months or years to improve. Sometimes there is permanent pain and stiffness.
• Slow or incomplete recovery because of damage caused by pressure on the nerve before the procedure. For 3 in 4 people, symptoms of carpal tunnel syndrome improve quickly.
• Failure to improve your symptoms.

Consequences of this procedure

• pain
• scarring of your skin

You should be able to go home the same day.

Keep your hand raised and bandaged for 2 days. It is important to gently exercise your fingers, elbow and shoulder to prevent stiffness.

Regular exercise should help you to return to normal activities as soon as possible. Before you start exercising, ask the healthcare team or your GP for advice.

Your symptoms may continue to improve for up to 6 months. However, it can take up to 12 months.

Carpal tunnel syndrome causes numbness in your thumb, index and middle fingers. A carpal tunnel release should improve your symptoms and prevent permanent nerve damage.