Do I Need Carpal Tunnel Surgery?

Most of us use our hands almost every minute of the day without ever giving it a second thought. But if you have carpal tunnel syndrome, the pain, numbness, and tingling in your fingers get your attention. Treatments like wrist braces and corticosteroids can help, but in more severe cases, you may need surgery.

Carpal tunnel syndrome is caused by pressure on your median nerve. This is what gives you feeling in your thumb and all your fingers except your pinky. When the nerve goes through your wrist, it passes through the carpal tunnel -- a narrow path that’s made of bone and ligament. If you get any swelling in your wrist, that tunnel gets squeezed and pinches your median nerve. That, in turn, causes your symptoms.

Whether you’ve decided to have surgery or are still thinking about it, you should know what to expect.

When Would My Doctor Suggest Surgery?

Over time, carpal tunnel syndrome can weaken the muscles of your hands and wrists. If symptoms go on for too long, your condition will keep getting worse.

If any of these sound like your situation, your doctor might suggest surgery:

  • Other treatments -- like braces, corticosteroids, and changes to your daily routine -- haven’t helped.
  • You have pain, numbness, and tingling that don’t go away or get better in 6 months.
  • You find it harder to grip, grasp, or pinch objects like you once did.

What Are My Surgery Options?

There are two main types of carpal tunnel release surgery: open and endoscopic. In both cases, your doctor cuts the ligament around the carpal tunnel to take pressure off the median nerve and relieve your symptoms. After the surgery, the ligament comes back together, but with more room for the median nerve to pass through.

  • Open surgery involves a larger cut, or incision -- up to 2 inches from your wrist to your palm.
  • In endoscopic surgery, your surgeon makes one opening in your wrist. He may also make one in your arm. These cuts are smaller, about a half-inch each. He then places a tiny camera in one of the openings to guide him as he cuts the ligament.

Because the openings are smaller with endoscopic surgery, you may heal faster and have less pain. Ask your doctor which operation is best for you.

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Results and Risks

Most people who have carpal tunnel surgery find that their symptoms get cured and don’t come back. If you have a very severe case, surgery can still help, but you may still feel numbness, tingling, or pain from time to time.

Risks come with any operation. For both types of carpal tunnel release surgery, they include:

  • Bleeding
  • Damage to your median nerve or nearby nerves and blood vessels
  • Infection of your wound
  • A scar that hurts to touch

What’s the Surgery Like?

First, you’ll get local anesthesia -- drugs to numb your hand and wrist. You may also get medicine to help keep you calm. (General anesthesia, which means you will not be awake during surgery, is not common for carpal tunnel syndrome).

When the operation is finished, your doctor stitches the openings shut and puts a large bandage on your wrist. This protects your wound and keeps you from using your wrist.

Your doctor and nurses will keep an eye on you for a little while before letting you go home. You’ll likely leave the hospital the same day. Overnight stays are rare.

How Long Does It Take to Heal?

You may get relief from symptoms the same day as your surgery, but complete healing takes longer. Expect to have pain, swelling, and stiffness after the operation. Your doctor will let you know what medicines might help. You may have some soreness for anywhere from a few weeks to a few months after surgery.

Your bandage will stay on for 1-2 weeks. Your doctor may give you exercises to do during this time to move your fingers and keep them from getting too stiff. You can use your hand lightly in the first 2 weeks, but it helps to avoid too much strain.

Slowly, you can get back to more normal activities, like:

  • Driving (a couple of days after surgery)
  • Writing (after a week, but expect 4-6 weeks before it feels easier.)
  • Pulling, gripping, and pinching (6-8 weeks out, but only lightly. Expect 10-12 weeks before your full strength returns, or up to a year in more severe cases.)

Your doctor will talk to you about when you can go back to work and whether you’ll be limited in what you can do.

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Will I Need Occupational Therapy?

If you do, your doctor will suggest it once your bandage comes off. You’ll learn exercises to improve your hand and wrist movement, which can also speed up healing.

Some people find that their wrists aren’t as strong after surgery as they were before. If this happens to you, occupational therapy can help increase your strength.

WebMD Medical Reference Reviewed by Lisa Bernstein, MD on October 02, 2016

Sources

SOURCES:

American Academy of Orthopedic Surgeons, OrthInfo: “Carpal Tunnel Syndrome.”

Mayo Clinic: “Carpal Tunnel Syndrome.”

NIH, National Institute of Neurological Disorders and Strokes: “Carpal Tunnel Syndrome Fact Sheet.”

Johns Hopkins Medicine: “Carpal Tunnel Release.”

University of Washington Orthopaedics and Sports Medicine: “Carpal Tunnel Syndrome.”

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