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.
Description
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.
First, you will receive numbing medicine (anesthesia) so that you will not feel pain during surgery. You may be awake but you will also receive medicines to make you relax.
In carpal tunnel release, the surgeon will cut through this ligament to make more space for the nerve and tendons.
First your surgeon will make a small surgical cut in the palm of your hand near your wrist.
Then your surgeon will cut the carpal transverse ligament to ease the pressure on the median nerve. Sometimes, tissue around the nerve is removed as well.
Your surgeon will then close the skin and tissue underneath with sutures (stitches).
Sometimes surgeons do this procedure using a tiny camera that is attached to a monitor. The surgeon inserts the camera into your wrist through a very small surgical cut and looks at the monitor to see inside your wrist. This is called endoscopic surgery. The instrument used is called an endoscope.
Why the Procedure is Performed
Patients with symptoms of carpal tunnel syndrome usually try non-surgical treatments first. These are:
Anti-inflammatory medicines
Occupational therapy
Workplace changes to improve your seating and how you use 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. If the test shows that the problem is carpal tunnel syndrome, carpal tunnel release surgery may be recommended.
If the muscles in the hand and wrist are getting smaller because the nerve is being pinched, surgery will usually be done right away.
Risks
Risks of carpal tunnel release are:
Allergic reactions to medicines
Bleeding
Infection
Injury to the median nerve or nerves that branch off of it
Rarely, injury to another nerve or blood vessel (artery or vein)
Scar sensitivity
Before the Procedure
Always tell your health care provider what drugs you are taking, even drugs, supplements, or herbs you bought without a prescription.
After the Procedure
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. After the splint or bandage is removed, you will begin motion exercises or a physical therapy program.
Outlook (Prognosis)
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.