When Carpal Tunnel Requires Surgery

Numbness, pain, and tingling in the hand and forearm is often a sign of carpal tunnel. The condition is caused by sustained pressure on the median nerve, a major nerve that runs from the arm through the wrist and into the hand. Carpal tunnel is often caused by repetitive actions as well as poor ergonomics. Many people can manage the injury with at-home care, but in some cases, carpal tunnel release surgery is necessary.

Choosing a surgical approach

To treat carpal tunnel, 1 of 2 surgeries may be performed. Endoscopic surgery is a minimally invasive option, while open carpal tunnel release is a more involved surgery. During endoscopic surgery, the surgeon uses laparoscopic probes with cameras and small surgical tools to trim the ligaments around the median nerve to alleviate pressure. Meanwhile, an open release requires larger incisions between the wrist and palm to access the ligaments.

Recovery expectations

While both endoscopic and open carpal tunnel release surgeries do require some recovery time, the minimally invasive option usually sees patients heal faster. Likewise, individuals may have less pain. The total healing time can vary depending on the type of surgery performed, the severity of the carpal tunnel, and the patient’s willingness to adhere to post-op instructions. In general, recovery can range from a few days to a few months.

Is assistance needed?

Even though carpal tunnel release is outpatient, enlisting help is a good idea. In most cases, local anesthesia will be applied on the day of surgery. Some people may be given general anesthesia and will be very groggy or disoriented immediately following surgery. A patient’s hand will be bandaged, making essential tasks like driving unsafe. Likewise, a person may need help getting food, handling lightweight items, and filling doctor-recommended prescription pain medications because of reduced mobility. As a general guide, people undergoing any kind of surgery, no matter how minor, should enlist help for at least the first day.

A longer road to recovery

Individuals recovering from carpal tunnel release surgery should be realistic about the recovery timeline. For example, an individual with very poor hand function and grip strength leading into surgery may need more time to heal and regain full mobility. As a result, trying to be completely independent too soon can do more harm than good. Avoid setbacks by asking for help when needed and avoiding activities like lifting heavy boxes, children, or pets.

Practical implications

While carpal tunnel release surgery often provides symptom relief the very next day, there are practical realities that need to be considered. Immediately returning to work may not be possible, depending on an individual's career choice. People working at a desk in an office can usually return to work in a few days, while other individuals may not be so lucky. For example, a person who works in heavy manual labor may need to be out of work for closer to 4-6 weeks after surgery.

Be realistic about recovery

Most people that seek surgical treatment for carpal tunnel report positive outcomes, but recovery times vary widely. A patient’s adherence to post-surgical treatments is equally essential to ensuring improved hand, wrist, and forearm function. Remember that even the most independent individual needs to be prepared to rely on people for emotional and practical support in the immediate days after surgery.