Surgery may be necessary in severe or persistent carpal tunnel syndrome. Patients who have persistent numbness, muscle wasting, severe findings on nerve conduction studies or who are resistant to non-operative treatments may need surgery. The surgery for carpal tunnel syndrome is called a carpal tunnel decompression, it involves cutting the band of tissue, called the transverse carpal ligament, in the wrist that crosses the median nerve to lessen the pressure on your nerve, and the outcome is usually good. Carpal tunnel syndrome surgery is usually performed as a day-case operation under local anaesthetic. The procedure usually takes about 15 minutes.
Factors that determine success or failure are the age of the patient, duration of symptoms, diabetes mellitus, and if there is weakness (which usually is a late sign).
After the surgery, the gap in the ligament heals with scar tissue, but with more room for the median nerve to pass through.
After carpal tunnel decompression, you can use your hand straight away but it is important to elevate your hand regularly while resting. This this video we demonstrate how to elevate your hand after surgery:
Surgery is not without risk and in this video we discuss the risks of a carpal tunnel decompression operation:
The recovery from carpal tunnel syndrome is relatively quick. In this video we discuss return to activity after carpal tunnel decompression: