Light at the end of the carpal tunnel: FAQs about surgery

Carpal tunnel syndrome has various causes and numerous symptoms.

Here to detail how it's treated with surgery and commonly-asked questions about what's involved in this procedure, is highly-skilled consultant plastic, reconstructive and hand surgeon Mr Alexander Armstrong.   

What is carpal tunnel?

Carpal tunnel is a condition that causes pain, weakness, tingling, and numbness in the hand and fingers due to compression of the median nerve in the wrist (carpal tunnel). Repetitive motions, such as typing or manual labour, or conditions, such as arthritis or diabetes, often cause it. It is also common during pregnancy.  Treatment options include splints, physiotherapy, steroid injection and surgery.

Some common symptoms of carpal tunnel syndrome include:

• Numbness, tingling, or burning sensations in the hand and fingers
• Weakness in grip strength
• Pain at night
• Difficulty with fine motor tasks

How long does carpal tunnel surgery take?

The surgery typically takes about 30 minutes. You'll be able to go home on the same day. The procedure is mostly performed awake under local anaesthetic injection to numb the palm. We will make a small incision in the heel of the palm during the procedure, and divide the ligament pressing on the median nerve to relieve the compression. After surgery, a period of rest and physiotherapy is typically recommended to help the wrist heal and regain strength.

How long does it take to recover from carpal tunnel surgery?

Recovery time from carpal tunnel surgery varies from person to person, but most people notice an improvement in their symptoms right after the procedure. The time it takes to recover fully can range from several weeks to a few months, depending on several factors, such as the severity of the condition, the type of surgery performed, and the patient's overall health. Most people can gradually return to normal activities as the palm begins to heal, and they regain strength and function in their hand and wrist.

It's important to remember that every hand is different, and recovery time will vary for different people. To ensure a successful recovery, it's also important to follow the post-operative instructions and attend any follow-up appointments with a doctor.

How long will it take before I can drive after carpal tunnel surgery?

You won’t be able to drive immediately after your carpal tunnel release surgery. Most people can begin driving again within 1 to 2 weeks afterwards. However, this can vary depending on the patient’s recovery rate, and their doctor’s specific instructions. It's essential that your hand and wrist recover to full strength again before driving.

Before you get behind the wheel, you should:
 

• Be able to grip and control the steering wheel appropriately
• Be able to sit comfortably and at ease
• Be able to perform an emergency stop
• Have full feeling back in your wrist and hand
• Make sure you have no pain or discomfort while driving
• Ensure any medication or painkillers don't make you drowsy

When is carpal tunnel bad enough for surgery?

Every patient is different. Not everyone requires surgery when suffering from carpal tunnel. Despite this, carpal tunnel syndrome surgery is typically considered when other conservative treatments have failed to provide adequate symptom relief. The decision to have surgery is usually made when the following criteria are met:

• Symptoms are severe and interfere with daily activities
• Numbness and tingling persist and are affecting hand function
• Weakness in the hand is worsening
• Non-surgical treatments, such as splints, steroid injection and physiotherapy, have not provided enough improvement
• Ultimately, the decision to have surgery for carpal tunnel syndrome is a personal one and depends on the individual's symptoms and the severity of their condition.

How to sleep after carpal tunnel surgery?

After carpal tunnel surgery, it's important to protect your wrist and hand while you sleep to promote healing and reduce the risk of postoperative complications. Here are some tips to help you sleep comfortably:

• Keep your wrist elevated: Keeping your wrist elevated on a pillow can help reduce swelling and improve circulation.
• Sleep on your back: Sleeping on your back can help reduce pressure on your wrist. If you are a side sleeper, try sleeping on the side opposite the affected wrist.
• Avoid sleeping on your hand: Try to avoid sleeping on your hand or wrist, as this can put pressure on the affected area.

Can carpal tunnel return after surgery?

It’s uncommon for carpal tunnel to return after surgery. However, in order to minimise the risk of it returning, it's important to follow proper post-operative care and do physiotherapy or other rehabilitation exercises to regain wrist strength and flexibility. In some cases, modifications to daily activities and work habits may be necessary to prevent repetitive motions that can lead to the recurrence of symptoms.

Arrange a consultation to address your carpal tunnel syndrome surgery concerns via Mr Armstrong's Top Doctors profile.