You have had either open-release or endoscopic-release carpal tunnel surgery to relieve the symptoms of carpal tunnel syndrome. Open-release surgery generally involves more recovery time since it is more traumatic, assuming there are no complications. The results of either technique are extremely variable, and you can expect some post surgical pain and discomfort. Recovery and return to work may take weeks or months. Whether or not you have complete recovery depends largely on your symptoms and your general health.
Introduction
The goal of surgery is to cut the transverse carpal ligament inside the carpal tunnel of the wrist to relieve pressure on the median nerve. However, open-release surgery, while more commonly performed, is also more traumatic. It involves making a two-inch long incision in the palm and wrist to expose and cut the ligament. In contrast, endoscopic-release surgery requires one or two small holes in the wrist and hand for insertion of endoscopic equipment in order to view and cut the ligament. Recovery from open-release surgery takes longer than endoscopic-release surgery. However, the course of recovery is similar using both techniques.
After Surgery
For the first few days after surgery, you will have tenderness and swelling at the surgical site. This is normal, and you can take pain medicines and apply ice to control the swelling. It will be uncomfortable to move your hand and fingers, but you must perform hand and finger exercises to avoid the formation of adhesions. You will change your bandages to keep them clean, and you will avoid any strenuous hand activities, especially grasping and pinching. You will return to your doctor in about two weeks to remove stitches. Returning to work will depend on the rate of healing and usually takes between a few weeks to months.
Possible Discomfort
Immediately after surgery the majority of patients report discomfort, stiffness, tenderness or mild pain either around the incision site or in the fingers and hand. This can last for weeks to several months. Eventually, these symptoms begin to wane and in time most patients have little or no remaining discomfort. Splinting may help relieve these symptoms if the hand must be used to perform daily activities.
Residual Symptoms
Most people experience at least some resolution of symptoms, especially numbness, almost immediately after surgery. Pain reduction may take weeks or months to resolve. It is not at all uncommon for some symptoms, especially partial pain, to persist after the surgery. The residual symptoms may be permanent. While rarer, surgery can fail completely resulting in little or no resolution of symptoms.
Recurrence of Symptoms
While reports of recurrence of symptoms are varied, there is no doubt that such is not uncommon. Symptoms may disappear completely only to emerge months or years later. Such may be due to excessive scar formation as well as aggravating the hand a second time or an underlying medical condition causing the carpal tunnel syndrome to manifest again. Most patients elect to not have a second surgery if the first one failed.
References
- "American Family Physician"; Management of Carpal Tunnel Syndrome, A. Viera; July 2003
- "Hand"; Current Status of Outcomes Research in Carpal Tunnel Surgery; K Chung; June 2006
- Univ. of Maryland Medical Center: Carpal Tunnel syndrome - Surgery
- Boston Hand: Carpal Tunnel Release Surgery
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