Carpal tunnel release is surgery to treat carpal tunnel syndrome. Carpal tunnel syndrome is pain and weakness in the hand that is caused by pressure on the median nerve in the wrist. The median nerve and the tendons that flex (or curl) your fingers go through a passage called the carpal tunnel in your wrist. This tunnel is narrow, so any swelling can pinch the nerve and cause pain. A thick ligament (tissue) just under your skin (the carpal ligament) makes up the top of this tunnel.
Causes
People with symptoms of carpal tunnel syndrome usually try nonsurgical treatments first. These may include:
- Anti-inflammatory medicines
- Therapy to learn exercises and stretches
- Workplace changes to improve your seating and how you use your computer or other equipment
- Wrist splints
- Shots of corticosteroid medicine into the carpal tunnel
If none of these treatments help, some surgeons will test the electrical activity of the median nerve with an EMG (electromyogram). If the test shows that the problem is carpal tunnel syndrome, carpal tunnel release surgery may be recommended.
If the muscles in your hand and wrist are getting smaller because the nerve is being pinched, surgery will usually be done soon.
Treatment
The surgery is done in the following way:
- First, you receive numbing medicine so that you do not feel pain during surgery. You may be awake but you will also receive medicines to make you relax
- A small surgical cut is made in the palm of your hand near your wrist
- Next, the ligament that covers the carpal tunnel is cut. This eases the pressure on the median nerve. Sometimes, tissue around the nerve is removed as well
- The skin and tissue underneath your skin are closed with sutures (stitches)
Sometimes this procedure is done using a tiny camera attached to a monitor. The surgeon inserts the camera into your wrist through a very small surgical cut and views the monitor to see inside your wrist. This is called endoscopic surgery. The instrument used is called an endoscope.
Recovery
This surgery is done on an outpatient basis. You will not need to stay in the hospital.
After the surgery, your wrist will probably be in a splint or heavy bandage for about a week. Keep this on until your first doctor visit after surgery, and keep it clean and dry. After the splint or bandage is removed, you will begin motion exercises or a physical therapy program.
Carpal tunnel release decreases pain, nerve tingling, and numbness, and restores muscle strength. Most people are helped by this surgery.
The length of your recovery will depend on how long you had symptoms before surgery and how badly damaged your median nerve is. If you had symptoms for a long time, you may not be completely free of symptoms after you recover.
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