Carpal Tunnel Release Surgery

Carpal tunnel release surgery is a procedure used to relieve pressure on the median nerve in the wrist, which becomes compressed in people with carpal tunnel syndrome (CTS). The surgery involves cutting the transverse carpal ligament, which forms the roof of the carpal tunnel, to create more space for the nerve and reduce symptoms like numbness, tingling, and hand weakness.

This operation is most commonly performed when non-surgical treatments, such as wrist splinting, steroid injections, or activity modifications, no longer provide adequate relief. It may also be recommended in cases where symptoms are worsening or begin to affect hand function, grip strength, or sleep.

This guide will cover everything you need to know about carpal tunnel release surgery, including:

• When surgery is recommended, and the symptoms it aims to treat
• How the procedure is performed, including the different surgical approaches
• What to expect during recovery and rehabilitation
• Potential risks and complications associated with the procedure
• Answers to frequently asked questions about the surgery

Whether you’re considering carpal tunnel release for yourself or supporting someone through the decision, our guide provides clear, reliable information to help you understand the process and what it involves.

What is Carpal Tunnel Release Surgery?

Carpal tunnel release is a surgical procedure performed to relieve pressure on the median nerve, which passes through a narrow space in the wrist called the carpal tunnel. When this nerve becomes compressed – often due to swelling, inflammation, or thickened tissue – people may experience symptoms such as numbness, tingling, or weakness in the hand and fingers.

The goal of surgery is to reduce this pressure by cutting the transverse carpal ligament, a strong band of tissue that forms the roof of the carpal tunnel. Dividing this ligament increases the tunnel’s space, easing pressure on the nerve and helping to improve symptoms.

Carpal tunnel release can be performed using one of two main techniques:

• Open release: This involves a small incision in the palm to access and divide the ligament directly.
• Endoscopic release: This technique uses one or two smaller incisions and a miniature camera to guide the surgeon in cutting the ligament with specialised instruments.

Both methods are designed to achieve the same result – long-term relief of carpal tunnel symptoms – and are typically carried out as day procedures under local anaesthetic.

Why is Carpal Tunnel Release Surgery Performed?

Carpal tunnel release surgery is performed to treat carpal tunnel syndrome, a condition caused by compression of the median nerve as it passes through the wrist. The median nerve controls sensation in the thumb, index, middle, and part of the ring finger, as well as some hand movements. When the nerve is compressed, it can lead to symptoms such as:

• Tingling or numbness in the fingers (especially at night)
• A “pins and needles” sensation in the hand
• Weak grip or difficulty holding objects
• Pain radiating from the wrist into the forearm or hand

The surgery is usually recommended when non-surgical treatments have failed to provide sufficient relief. These might include:

• Wrist splinting, especially at night
• Anti-inflammatory medications
  
• Steroid injections
  
• Activity modifications to reduce strain

If symptoms persist, worsen, or begin to interfere with sleep, daily tasks, or work, surgery may be advised to prevent permanent nerve damage. Early surgical intervention is particularly important when there is ongoing numbness, muscle wasting at the base of the thumb, or loss of hand strength.

How is Carpal Tunnel Release Surgery Performed?

Carpal tunnel release surgery is a short, low-risk operation typically done under local anaesthetic as a day case, meaning most patients go home the same day. The goal of the procedure is to relieve pressure on the median nerve by dividing the transverse carpal ligament, the tissue that forms the top of the carpal tunnel.

There are two main surgical approaches:

Open Carpal Tunnel Release

In this method, the surgeon makes a small incision (usually around 3–5 cm) in the palm near the base of the hand. This allows direct access to the transverse carpal ligament, which is carefully cut to enlarge the tunnel. The incision is then closed with stitches.

Endoscopic Carpal Tunnel Release

This technique involves one or two smaller incisions in the wrist and/or palm. A thin, flexible tube with a camera (endoscope) is inserted, allowing the surgeon to see inside the carpal tunnel. Surgical instruments are then used to cut the ligament under video guidance.

Both methods aim to achieve the same result – relief of nerve pressure – but the endoscopic approach may allow for a slightly faster recovery and smaller scars. Your surgeon will help determine which option is most suitable based on the specifics of your case, including symptom severity, medical history, and personal preference.

Recovery & Rehabilitation

Recovery from carpal tunnel release surgery is usually straightforward, but the timeline can vary depending on the surgical method used, the severity of nerve compression before surgery, and individual factors such as age and general health.

Immediately After Surgery

Most patients can go home the same day. The hand and wrist may feel sore, swollen, or bruised for a few days. A light dressing or bandage is applied, and patients are encouraged to gently move their fingers soon after the procedure to prevent stiffness.

Return to Daily Activities

• Light use of the hand (e.g. dressing, light typing) may be possible within a few days.
• Driving is often resumed after 1 to 2 weeks, once grip strength and comfort return.
• Returning to work depends on the nature of the job:
  • Office-based or sedentary work: usually within 1–2 weeks.
  • Manual or repetitive work: may take 4–6 weeks or longer.

Hand Therapy and Exercises

In some cases, especially where symptoms were severe or longstanding, hand therapy may be recommended to restore strength, flexibility, and function. Your care team may provide exercises to support recovery and reduce stiffness or scar sensitivity.

Full Recovery

While many people experience immediate relief from tingling and pain, recovery of strength and fine motor skills may take several weeks. In more severe cases -particularly where there was prolonged nerve compression – recovery may take several months, and some symptoms may persist.

Follow-up appointments are usually scheduled to monitor healing, remove stitches if necessary, and check nerve function improvement.

Risks & Potential Complications

Carpal tunnel release surgery is considered safe, and most people recover without any serious issues. However, as with any surgical procedure, there are some risks to be aware of.

Common Side Effects

• Soreness, swelling, or bruising around the incision site are expected in the days following surgery.
• Scar sensitivity or tightness may develop temporarily but usually improves with time and hand exercises.
• Stiffness or mild weakness in the hand may occur during the early recovery period.

Potential Complications

Though uncommon, complications can include:

• Infection at the wound site
• Bleeding or haematoma
  
• Injury to nearby nerves or blood vessels
  
• Delayed healing or discomfort around the scar
• Incomplete symptom relief – especially if nerve damage was already advanced before surgery
• Complex regional pain syndrome (CRPS) – a rare, chronic pain condition

Most of these complications are rare and can be managed effectively if identified early. Choosing an experienced surgical team, following post-operative instructions, and attending follow-up appointments all help reduce risk and support recovery.

Frequently Asked Questions About Carpal Tunnel Release Surgery

How long does carpal tunnel release surgery take?

The procedure usually takes around 20 to 30 minutes, and most patients can go home the same day.

Is the surgery painful?

The surgery itself is performed under local anaesthetic, so you won’t feel pain during the procedure. Some soreness and discomfort after surgery is normal but can be managed with over-the-counter pain relief.

What’s the difference between open and endoscopic surgery?

Both approaches aim to relieve pressure on the median nerve.

• Open surgery involves a single incision in the palm, giving direct access to the ligament.
• Endoscopic surgery uses smaller incisions and a camera to guide the procedure, which may lead to a quicker recovery and smaller scars.

Will my symptoms go away completely?

Many people notice an improvement in numbness and tingling shortly after surgery, especially if symptoms were not longstanding. If the nerve was compressed for a long time, full recovery may take longer, and some symptoms may persist.

What are the alternatives to surgery?

Non-surgical options include:

• Wrist splinting (especially at night)
• Anti-inflammatory medication
  
• Steroid injections
  
• Activity modification

These treatments may provide relief in mild or early cases but are often less effective for persistent or severe symptoms.