The median nerve runs through a tight tunnel on the front of your wrist, together with the tendons that bend your finger.

The tunnel becomes too tight and can cause pressure on the nerve which usually results in pain or numbness in the thumb, index and middle fingers. Symptoms are often worse at night.

Symptoms may improve if there is an underlying cause that is treated.

In those people with no underlying cause, symptoms usually continue but can get better or worse for no known reason.

If the compression of the nerve is severe and you do not have any treatment for a long time, the nerve may become permanently damaged.

This can cause some of the muscles at the base of your thumb to waste away and you may get permanent numbness in your hand.

Having surgery at this stage may not be able to put right the damage already done.

We understand that surgery can be daunting, but do not worry our specialist medical staff will be there to answer any worries you may have. 

During surgery your surgeon will make a small cut on the palm of your hand. They will cut through the tight ligament (called the flexor retinaculum) that forms the roof of the carpal tunnel. When the pressure is built up in the carpal tunnel, the median nerve is unable to complete its function which creates the tingling sensation. By splitting the carpal ligament, the pressure is then relieved allowing the median nerve to work. 

Carpal tunnel release is a day-case procedure so you will go home on the same day as surgery. The surgery usually takes around 20 minutes to complete. 

You will be given local anaesthesia so you will be awake but you won’t feel any pain. 

Your surgeon will place a tourniquet on your arm to take blood pressure. Once the tourniquet is inflated and no blood is flowing to your hand, the procedure will start. 

The cut will be made in your palm where your surgeon will be able to see the carpal ligament in order to divide it and release the pressure. 

Your surgeon will close the skin with stitches.

When the local anaesthetic begins to wear off you will begin to feel tingling in your hand. It is important to continue wiggling and moving your fingers to maintain steep blood flow to your hand and to reduce any stiffness that may occur. 

You will be provided with some medication for possible pain after surgery. This usually occurs after about 2 days in the area that your surgeon cut. Pain relief medication will include ibuprofen and paracetamol.  

14 days after surgery you will be able to remove the bandage but it is important that you continue to keep the area dry and clean.

10-14 days after surgery your stitches will be removed (unless your surgeon used dissolvable stitches in which case they will not need to be removed). You may notice a scar on your palm which you can treat with special ointments.  

You may feel your hand is weaker after surgery but it is important to build the strength up slowly. You may want to see a physiotherapist at this point. 

You should be able to return to normal fully working activities about 19 days after the surgery but you will be able to return to light activities at 12 days

For 3 in 4 people, symptoms of carpal tunnel syndrome improve quickly. However, recovery can be slower or less complete because of damage caused by pressure on the nerve before the operation.

Your symptoms may continue to improve for up to 6 months.

Surgery is usually sage and effective but complications can happen. You need to know about them to help you make an informed decision about surgery.

As with any procedure, there are risks associated with it. For carpal tunnel release these may include: 

• Sensitivity where the incision was made and scarring of the skin. Tenderness of the scar is common for 6 weeks and usually gets better. As the cut lies in one of your skin creases, the scar usually becomes almost invisible over time.
• Nerve damage - numbness us your thumb, index and middle fingers caused by damage to the median nerve or one of its branches during the operation.
• Infection of the surgical wound. It is usually safe to shower after two days if you keep your wound dry and covered. Please let the hospital team know if you get a high temperature or if your wound becomes red, sore or painful. An infection usually settles with antibiotics. 
• Pain when applying pressure to the hand. The cut is usually small and not too painful once the anaesthetic has worn off.