After Carpal Tunnel Surgery

If you are undergoing carpal tunnel surgery, your surgery likely will be either open release or endoscopic release. Open release surgery usually involves more recuperation time, while recuperation from endoscopic release surgery may be shorter. However, you can expect a similar recovery course from both techniques. The events immediately after surgery and those occurring from weeks to months afterwards are mostly predictable. However, in some cases complications may occur.

Introduction

According to the National Institutes of Health (NIH), carpal tunnel syndrome occurs when the median nerve is compressed by tissues inside the carpal tunnel of the wrist. This causes pain, burning, numbness or tingling in the hand and fingers. Most patients obtain good results with nonsurgical treatments but some choose to have surgery.

Surgical Objective

Carpal tunnel surgery's objective is to cut the transverse carpal ligament in the wrist. This causes the ligament to snap open, creating more room inside the carpal tunnel, resulting in reduced pressure on the median nerve and diminished symptoms. Carpal tunnel surgery can take two forms; open and endoscopic release surgery. Open release surgery involves making a two-inch long slit in the palm to access and cut the ligament, whereas endoscopic release surgery involves making one or two small holes in the palm to insert a camera and other equipment to see and cut the ligament.

Immediately After Surgery

According to the University of Maryland Medical Center, you will be required to rest when you get home after surgery. You must keep your hand elevated above your heart level. You will be instructed to use an ice pack on your hand and wrist several times daily to control swelling, as well as wear a splint most of the time. To minimize pain, your doctor may prescribe analgesics. After a day or two, you can begin performing light exercises with your hand and fingers, as well as your arm and shoulder. Avoid doing anything strenuous with your hands, including typing or heavy gripping, up to about six weeks after surgery.

Weeks After Surgery

A dressing will be on your hand until you return to your surgeon about two weeks after surgery to remove the stitches. Do not let the bandages get wet. The scar may still be painful for several weeks, so after you finish any prescription analgesics, you can take over-the-counter analgesics like ibuprofen. Continue with exercises.

Months After Surgery

The NIH reports that recovery can be difficult and painful, and full recovery can take months or longer if complications occur. Complications may include reaction to anesthesia, infection, nerve or tendon damage, scar formation inside the wrist, and severe pain at the surgical site. For several weeks to months after surgery, you will likely experience a loss of grip strength but that will improve with exercises. However, oftentimes full grip strength does not recover. If tendons or nerve tissues were damaged during surgery, it may take even longer--if at all--to recover grip strength; success is dependent on the extent of damage to these tissues. Your may receive physical or occupational therapy after a few weeks. The amount depends on your health and abilities to perform activities at home. Therapy will be combined with exercises, such as finger stretching and range-of-motion techniques performed several times daily. These help restore strength, minimize scarring, strengthen muscles and improve dexterity. You also will be advised about ways to perform your daily tasks to reduce hand stress.

Outcome

Timothy Straub reports in the 1999 issue of Arthroscopy that long-term recovery and surgical success is variable and depends on numerous factors, such as symptom severity and length of time you had symptoms before surgery. Due to the variability in outcomes, it is not unusual for patients to report unsatisfactory results. Recurrence of symptoms is uncommon.