Healthy Living

What is Carpal Tunnel Release?

What is Carpal Tunnel Release?

Key Takeaways

  • Carpal tunnel release is an operation that treats carpal tunnel syndrome when non-surgical treatments fail to.
  • When non-surgical treatments fail to alleviate the symptoms of CTS, some surgeons will first have the electrical activity of the median nerve measured using an electromyogram (EMG) to confirm the diagnosis of CTS.
  • Carpal tunnel syndrome (CTS) is thought to be usually caused by injury of the carpal tunnel through such things as repetitive actions of the wrists and hands, the use of vibrating machines, and wrist fractures or sprains.

Carpal tunnel release surgery is a medical procedure that is used to relieve symptoms caused by carpal tunnel syndrome (CTS). Such symptoms include pain in the hand, tingling, and numbness. The procedure involves separating the ligaments in your hand to help relieve pressure on the nerve that regulates feeling and movement. Both early and mild symptoms of carpal tunnel syndrome are not usually treated with surgery. However, if the symptoms persist and intensify after about 6 months of non-surgical treatment, you may consider going for carpal tunnel release surgery.

CTS is thought to be usually caused by injury of the carpal tunnel through such things as repetitive actions of the wrists and hands, the use of vibrating machines, and wrist fractures or sprains.

When Would I Need Carpal Tunnel Release Surgery?

Patients with carpal tunnel syndrome will first try non-surgical methods before going for surgery. The most common non-surgical treatments for CTS are:

  • Wrist splints
  • Using anti-inflammatory medications
  • Injecting corticosteroids into the carpal tunnel
  • Therapy that involves stretching and other exercises
  • Modifying the position one assumes at work, such as the position of the arms, wrists, and hands relative to office equipment such as a computer

If all the above measures fail to alleviate the symptoms of CTS, some surgeons will first have the electrical activity of the median nerve measured using an electromyogram (EMG) to confirm the diagnosis of CTS. If the condition is indeed CTS, then your doctor may recommend carpal tunnel release surgery.

Preparation for Carpel Tunnel Release Surgery

Carpal tunnel release surgery is an outpatient procedure, meaning you can have the procedure and go home the same day. Before having the operation, you should let your doctor know about the medications, including any supplements and natural remedies, that you have been taking, with or without a prescription.

  • You should ask your doctor about the medicines that you can continue taking up to the operation date.
  • Your doctor might ask you to stop taking blood-thinning drugs. These include naproxen, aspirin, and ibuprofen, among others.
  • In case you smoke, you will be asked to try and stop, because smoking is known to slow down your body's healing processes.
  • You should let your doctor know if you have other illnesses or diseases such as herpes, the flu, fever, or a cold.
  • You should not eat or drink anything 6 hours before surgery.

You should follow all your doctors' instructions to the letter so that the operation and your recovery go smoothly. Your doctor will tell you what time you have to be in the hospital for the operation. Make sure you arrive on time.

Other things to ask your doctor about the surgery include:

  • Why is surgery recommended, especially in your case
  • What are the types of surgery possible in your case
  • What are the advantages of one type of surgical procedure over another 
  • What results can you expect after the operation 
  • What are the benefits, risks, and possible side effects of the procedure
  • Where and when would it be best to have the procedure
  • Who will operate on you and his/her qualifications
  • What is likely to or can happen if you don’t have the operation
  • Are there alternatives to surgery you still might try
  • Do the benefits come immediately
  • How much will the procedure cost you
  • What things can't you do after the surgery 
  • How long will recovery of the full use of your hand, wrist, and arm take
  • What activities won't you be able to do until you have recovered

The Procedure

There are two types of carpal tunnel release surgery. The traditional method, known as open release, is a procedure where the doctor cuts the wrist open. The second method is known as endoscopic tunnel release, where an endoscope (a thin, flexible tube with a camera at the end) is inserted into the wrist through a small incision. The camera is used to guide the surgeon as he/she performs the operation. The surgical tools are used in the surgery are inserted into the wrist through another incision in the palm.

In both surgical methods, a certain sequence needs to be followed:

  1. First, you will be asked to remove your clothes and wear a hospital gown. You will also be asked to remove any jewelry and accessories. 
  2. You will be given either a general or local anesthesia to numb the area of the surgical site.
  3. In open carpal tunnel release surgery, the doctor will make a 2-inch incision in the skin of your wrist. The doctor will use the common surgical instruments to make a cut on the carpal ligament and then enlarge the carpal tunnel.
  4. In endoscopic carpal tunnel release, the surgeon will make two ½-inch incisions. One cut is made in the wrist and the other in the palm. The doctor will then insert an endoscope through one of the incisions. After that, he/she will insert thin surgical instruments through the other incision to cut the carpal ligament and enlarge the carpal tunnel.
  5. After the operation, the doctor will close the wound with stitches.
  6. Your hand is then placed in a splint and bandaged heavily to prevent any movement of the wrist.

Once the procedure is complete, you will be observed for a short time and if things go well, you will be released and be able to go home. Some rare complications may require that you stay in the hospital overnight.

Risks 

As in other types of surgeries, carpal tunnel release surgery is accompanied by some risks. The risks include:

Complications from the Anesthesia  - Before the operation, your wrist is made numb through the use of a local anesthesia. In rare cases, general anesthesia is needed. When general anesthesia is used, you are put into a deep sleep for the entire surgery. Anesthesia carries some risks, such as when a person is allergic to the anesthesia used. This is why you should give your doctor all the health-related information he or she needs. Give all the questions your doctor asks sufficient attention and thought so that you cover everything and all potential issues are identified. 

Other complications that may arise from carpal tunnel release surgery include:

  • Excessive bleeding
  • Development of a sensitive scar
  • Infection
  • Injury to the median nerve and nerves that branch out of it
  • Damage to the neighboring blood vessels

Recovery

Recovery from carpal tunnel release surgery may take several weeks to months. Recovery may take longer if the nerve on the wrist is compressed for a long time during the operation. Getting physical therapy to strengthen your wrist and having your hand in a splint are included in the recovery process.

The Bottom Line

Carpal tunnel release surgery is an operation that is aimed at treating carpal tunnel syndrome when non-surgical treatments fail to. The main task of the procedure is to make room in the carpal tunnel when it has become too small, causing compression on your median nerve. It is a procedure with few risks and, although it causes pain and inconvenience, will ultimately relieve you of the unpleasant and debilitating symptoms of CTS.