Carpal Tunnel Release Surgery

Carpal tunnel release surgery involves surgically dividing the transverse carpal ligament (flexor retinaculum). This increases the space within the carpal tunnel and relieves pressure on the median nerve.

The procedure is performed using a mini-open technique under WALANT local anaesthesia (Wide Awake Local Anaesthesia No Tourniquet). Once the nerve has been decompressed, the surgical incision is closed with sutures and covered with a sterile dressing.

Recovery following surgery is gradual and varies from patient to patient. Restoration of sensation and muscle strength may take several weeks to months. In cases of long-standing or severe nerve damage, complete recovery may not be possible, and some numbness, pain, or weakness may persist.

After surgery, the wound and dressing should be kept clean and dry. Gentle, regular finger movements are recommended as tolerated, along with keeping the hand elevated during the first few days to help reduce swelling.

Until approved by the treating physician, patients should avoid forceful gripping, putting weight on the palm, and heavy manual activities. The return to work and sporting activities depends on individual recovery.

Routine long-term wrist immobilisation with a brace or specialised rehabilitation is generally not required following uncomplicated surgery unless otherwise recommended by the physician. Follow-up appointments and suture removal are scheduled according to the instructions provided in the surgical report.

Common postoperative symptoms include pain, swelling, bruising, scar tenderness, stiffness, and temporary reduction in grip strength. Pain in the palm around the released ligament, known as pillar pain, may also occur.

Less common complications include infection, wound-healing problems, and persistent or recurrent symptoms. Injury to a nerve, blood vessel, or tendon, as well as the development of complex regional pain syndrome (CRPS), is also possible.

Depending on the severity and duration of symptoms, non-surgical treatment options may be considered, particularly wearing a wrist splint or brace at night and modifying activities that place strain on the wrist.

If recommended surgery is declined, symptoms may persist or worsen. Continued severe compression of the median nerve can lead to damage that may not be fully reversible, even if surgery is performed at a later stage.