Carpal tunnel release is one of the most commonly performed hand operations. It is usually carried out as a day case under local anaesthetic. This guide takes you through preparation and recovery.
Carpal tunnel release is most often performed under local anaesthetic, so pre-assessment is straightforward. It usually takes place 1-2 weeks before surgery.
You will meet a member of the nursing team who will record your blood pressure and pulse, confirm your medical history, and answer any questions you have about the procedure.
Your surgeon will mark the wrist for surgery. If both wrists are affected, only one is usually operated on at a time.
Most regular medications can be continued. Blood thinners (warfarin, apixaban, rivaroxaban, aspirin) may need adjustment - your team will advise.
The operation is normally done under local anaesthetic injected into the wrist. You stay awake but feel no pain. General anaesthetic is rarely needed.
If you have diabetes, mention this. Good blood sugar control supports wound healing and reduces infection risk.
Tell your team if you have any skin infection, eczema flare or cuts near the wrist - surgery may need to be postponed.
You will be given a specific arrival time. Have no food from 2am on the day of surgery; you may drink clear water until 6am, unless your team gives you different instructions. Bring your medication list and any documents from the hospital.
You will be admitted to the day surgery unit, change into a gown, and be seen by the nursing, anaesthetic, and surgical teams before theatre.
Your surgeon will confirm the procedure, mark the operative side, and you will sign a consent form before going to theatre.
You will meet the anaesthetist. Many hand procedures are done under local or regional anaesthetic; some require general anaesthesia.
After surgery you will spend time in the recovery area where nurses monitor your vital signs until you are stable and comfortable.
Arrange for a family member or friend to collect you. You must not drive on the day of surgery if you have had a general anaesthetic or sedation.
Important: Seek urgent advice if you develop spreading redness, increasing pain, fever, or pus from the wound - these may indicate infection. Some scar tenderness ("pillar pain") on either side of the scar is normal for several months and gradually settles.
Avoid getting the wound wet until it is fully healed - usually 10-14 days. Use a waterproof cover when showering. Follow the dressing instructions you are given.
Keep the hand raised above the level of your heart as much as possible for the first 48-72 hours. This significantly reduces swelling, pain, and stiffness.
Do not wait until pain is severe before taking medication. Regular simple analgesia (paracetamol, and ibuprofen if appropriate for you) is more effective than waiting.
Unless told otherwise, gently bend and straighten all fingers regularly. Early movement helps prevent stiffness and reduces swelling.
Seek urgent advice if you develop spreading redness, increasing pain, swelling, discharge from the wound, a temperature above 38°C, or any new numbness - these may indicate infection or nerve problems.
Recovery timelines vary between patients and depend on the operation, the demands you place on the hand, and any other health conditions. The timeline below is a general guide - your surgical and hand therapy team will give you personal advice.
Brief nursing review, medication check, consent paperwork prepared.
The operation itself takes 10-20 minutes. You go home the same day, usually within an hour or two.
A bulky bandage is worn for the first few days. Gentle finger movement begins immediately to prevent stiffness.
Stitches are removed around 10-14 days at your follow-up appointment. Light activity can usually resume.
Heavy gripping, lifting, and manual work usually return by 6-12 weeks. Scar tenderness can persist for several months.
No. The operation is done under local anaesthetic. You will be awake but the hand will be completely numb. You will not see the operation as a screen is placed over your wrist.
Office or light desk work is usually possible within 1-2 weeks. Manual or heavy work typically requires 4-6 weeks off. Your team can provide a sick note.
You should not drive until you can grip the wheel firmly and perform an emergency stop safely - usually 1-2 weeks for an automatic car, often longer for a manual. Check with your insurer.
Tingling often improves within days. Numbness in long-standing cases may take months to recover and occasionally does not fully return - particularly if symptoms have been present for a long time.
A week-by-week guide to recovery. Individual timelines vary, so always follow the advice of your surgical and hand therapy team.
The aim of surgery is to relieve pressure on the median nerve by dividing the transverse carpal ligament. This usually settles the night-time tingling and numbness quickly and stops the nerve compression from getting worse. Around 9 in 10 patients are satisfied with the result.
The operation is normally done as a day case under local anaesthetic, with the hand fully numbed. A small incision is made in the palm and the transverse carpal ligament that forms the roof of the carpal tunnel is divided, creating more room for the median nerve. The skin is closed with stitches and a soft bandage is applied. It can also be performed endoscopically through one or two smaller incisions.
A neutral wrist splint worn at night reduces pressure in the tunnel and helps many people with mild or intermittent symptoms. It does not cure the underlying problem but can control symptoms well.
A single injection into the carpal tunnel can give substantial relief, sometimes for many months. It is useful for milder cases or as a temporary measure. Repeated injections are generally not advised.
Reasonable if symptoms are mild and not troublesome. There is a risk that ongoing compression leads to permanent numbness or muscle wasting over time.
Some numbness or tingling can persist, particularly in long-standing or severe cases. Recurrence after a complete release is uncommon.
The nerve or a small branch supplying the thumb muscles can rarely be injured, which may cause weakness or altered sensation. Care is taken to protect these structures.
A wound infection is usually superficial and settles with antibiotics. Deep infection is rare.
A poorly understood reaction causing prolonged pain, swelling, and stiffness of the hand. Most cases settle with hand therapy but recovery can be slow.
Aching and tenderness on either side of the scar is normal for several weeks to a few months and settles gradually.
Grip strength dips for a few weeks after surgery and usually returns to normal, or stronger, by around three months.
Some swelling of the hand and fingers is expected early on. Moving the fingers from day one helps it settle.
Mild carpal tunnel syndrome often stays stable, or improves, with night splinting and activity changes, so surgery is not always needed. However, if the nerve remains compressed the numbness can become constant and the small thumb muscles can waste away. Once muscle wasting and constant numbness are established, they may not fully recover even after a successful operation, so where nerve function is already affected earlier surgery tends to give the best result.