You usually lie on your back for carpal tunnel release surgery, with your arm stretched out on a special operating board by your side. Your nurse will check that you’re in a comfortable position. You may have a tourniquet around the top of your arm. A tourniquet is a tight cuff that stops blood flow in your arm during the operation.
You’ll be given local anaesthetic injections so you won’t feel any discomfort during the procedure. Your surgeon will test whether or not you can feel any pain before starting the operation. You may still feel some pressure once the anaesthetic is working. If this happens, tell your surgeon so that you can have a higher dose of anaesthetic.
The tourniquet is then inflated, a bit like a blood pressure cuff used to take blood pressure. It inflates until it completely stops blood flowing into your hand. Once the tourniquet is inflated, your surgeon can start the operation, which takes about 20 minutes.
Your surgeon will make a cut near the bottom of your palm, and divide your carpal ligament to relieve pressure on your median nerve. Once this is done, your surgeon will close the cut in your skin with stitches and apply a bandage. You may be advised to wear a wrist splint.
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After a local anaesthetic, it may take several hours before the feeling comes back into your wrist and hand. Take special care not to bump or knock your hand, and be extra careful around anything hot such as kettles or radiators. You may feel tingling in your hand as the anaesthetic wears off and the feeling in your wrist and hand returns.
Carpal tunnel release surgery isn’t usually painful. But you may need pain-relief medicines such as ibuprofen or paracetamol to ease any discomfort.
Your bandage will protect and support your hand, but you will still be able to wriggle your fingers. Keeping your arm up will help to reduce any swelling. Wriggle your fingers regularly to keep your blood flowing properly, and to reduce any stiffness.
Before you go home, your nurse will give you some advice about caring for your healing wound. It’s important to keep your bandage dry after your operation. This means wearing a rubber glove or plastic bag when you have a bath or shower.
You’ll usually be able to leave the hospital when you feel ready. Before you leave, you may be given a date for a follow-up appointment. This is usually six to eight weeks after your surgery.
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The stitches are removed 10 days after surgery. Protect the wound with a clean gauze and light bandage for 3 days following surgery (change daily or when soiled). Following removal of the dressing at 3 days you may shower and let water run over the incisions. Try to limit showers to no more than 5–7 minutes. After your surgery, you may be encouraged to do the following: Elevate your hand above your heart and move your fingers to reduce swelling and prevent stiffness. Ice the surgical site for a given amount of time, a few times a day. You may need to wear a splint or wrist brace for several weeks.
If you had open surgery on your dominant hand and you do repeated actions at work, you may be able to return to work in 6 to 8 weeks. Repeated motions include typing or assembly-line work. If the surgery was on the other hand and you do not do repeated actions at work, you may be able to return to work in 7 to 14 days. Individual return to work decision-making was largely influenced by the recommendations received. According to the views of participants, clinicians may be able to prepare patients better pre-operatively, especially with respect to function in the immediate post-operative period and by providing return to work guidance that can be tailored for individual work roles.
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For up to 2 weeks after surgery, avoid lifting things heavier than 0.5 to 1 kilogram and using your hand. This includes doing repeated arm or hand movements, such as typing or using a computer mouse, washing windows, vacuuming, or chopping food. Do not use power tools, and avoid activities that cause vibration.
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The stitches are removed 10 days after surgery. Protect the wound with a clean gauze and light bandage for 3 days following surgery (change daily or when soiled). Following removal of the dressing at 3 days you may shower and let water run over the incisions. Try to limit showers to no more than 5–7 minutes. Not everyone needs to see a physiotherapist after surgery unless there is a problem with scar pain or stiffness. Some general rules that are useful for everyone are: