If your symptoms haven’t improved after weeks or months of treatment, or if you have signs of progression like thumb muscle wasting or hand weakness, it’s time to consider surgery.
There are 2 main approaches to surgery. Both involve cutting through the ligament to release the pressure on your carpal tunnel nerve.
It’s usually done as day surgery in your doctor’s rooms, a clinic or hospital. Depending on the location and the services available, you can have it done with local anaesthetic only, local anaesthetic plus sedation (to make you calm and sleepy), or with general anaesthetic.
After surgery, the painful tingling in your hand should go immediately. Numbness in your fingertips may take a while to resolve.
If you’re having keyhole or mini-open surgery, be aware that sometimes your surgeon may realise during the surgery that it needs to be converted to an open procedure.
If you’re pregnant, surgery may not be the answer as your symptoms will probably go away once you’ve given birth. But if they become constant or severe consult a rheumatologist.
Keyhole (laparoscopic) carpal tunnel release surgery
Your surgeon usually makes two incisions: one in your wrist, less than 1 cm long and one in your hand, about 3 mm long. They insert a thin, flexible tube with a light and camera on the tip to see the area, then use an instrument with a scalpel on the tip to cut through the ligament and release the pressure on the nerve.
Afterwards your surgeon will apply bandages to keep the area clean and dry. You may not need sutures, as the incisions are small. You don’t have to wear a sling and you can use your hand normally except for driving and heavy work, which you should avoid for the first few weeks.
Open carpal tunnel release surgery
The surgeon makes one incision in your hand about 3 cm to 5 cm long to see the area directly and cut the ligament. You’ll need to have sutures to close the incision and a bandage to keep the area clean and dry. You may have to wear a sling for a few days after surgery.
Print this page and take it with you when you discuss your procedure with your surgeon.
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