What is carpal tunnel syndrome?

Carpal tunnel syndrome results from nerve compression at the wrist which can cause pain and discomfort. The median nerve is found near the tendons that flex the thumb and fingers and is held down by a tight ligament over the wrist bone. This ligament (flexor retinaculum) can thicken and compress the nerve and lead to:

• pins and needles in the thumb or other fingers
• numbness in the thumb or other fingers
• pain, often worse at night which can wake the person
• weakness, clumsiness or difficulty handling fine objects

What is carpal tunnel release surgery?

This is a very common, safe and reliable procedure, which aims to release the compressed nerve in the wrist, provide relief and reduce any further nerve damage.

Who does this procedure suit?

Those who have had diagnosed carpal tunnel syndrome, which can be caused by repetitive hand movements in certain occupations, age, pregnancy, diabetes, rheumatoid arthritis or thyroid disease. Your surgeon will also make sure that other conditions that mimic carpal tunnel syndrome are ruled out. These include conditions of the cervical spine or other common hand or wrist issues.

What results will I expect?

Most patients experience immediate improvement in their symptoms although this varies between patients. In the vast majority of patients, results are often life-long however very occasionally some patients may having recurring symptoms a few years after surgery.

What’s the first step?

During your first consultation your surgeon will discuss what you’d like to achieve, any expectations you have, questions about the procedure, medical history and current medication. Your surgeon will often arrange for nerve conduction studies to be performed to confirm the diagnosis prior to surgery. We will provide as much information as possible so that you feel comfortable and informed.

How do I prepare for surgery?

Please ensure you have arranged someone to drive you home after your surgery and to help you out at home for a few days. To reduce risk of bleeding and bruising please make sure to:

• Avoid pain relievers and Vitamin E two weeks before surgery. Panadol, and vitamins B and C are safe to use.
• Inform your surgeon if you take any herbal medicines that may affect clotting and the anesthetic.
• Avoid smoking before and after surgery so as not to restrict circulation to the area and delay healing. Giving up altogether is best.
• Inform us immediately if you’ve had any infection (cold or flu) the week before your surgery.

What happens on the day of my surgery?

We will guide you to prepare for surgery so that your procedure and recovery go smoothly.

• If your procedure is in the morning – do not eat or drink anything after midnight the night before.
• If your procedure is in the afternoon – do not eat or drink anything after 8.00am.

What should I expect during surgery?

Carpal tunnel release surgery is performed under general anesthetic or a light sedation with local anesthetic. Whichever you choose, you will be very comfortable and experience no pain during the surgery.

During the procedure, an incision is made over the wrist, the median nerve and its branches are carefully protected while the ligament (flexor retinaculum) is divided to release the compressed nerve. The incision is sutured and dressings applied. This procedure takes approximately 15-20 minutes and you will be able to go home a few hours later.

What should I expect after surgery?

• Your hand will be in a bulky bandage with a sling to wear at home. You may notice some bruising, which will fade in 4-5 days.
• Local anesthetic is used at the end of the procedure so that you have pain relief for the following 6-8 hours.
• Some discomfort is normal for the first few days which is easily relieved with oral analgesics. Keeping the hand elevated in a sling for 2 days will also help settle the pain.
• A follow-up appointment will be made 7-10 days after to assess that the wound has healed well and to remove any sutures. If necessary, we will refer you to our hand therapist for any recovery needed.
• After 2 weeks your hand can be used for light duties and return to heavier activities after 4-6 weeks. Your surgeon or hand therapist will guide you.

What are the risks and complications with this procedure?

As with any surgery there are some risks involved such as:

• Infection, excessive bleeding or bruising
• Nerve injury (less than 1%)
• Wrist pain/ache (in 5-10% of patients, which settles in 3-4 months)

Please call our office if you experience any of the following: excessive pain or bleeding, abnormal swelling or fever during the first 24 hours.