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Definition Return to top
Carpal tunnel release is surgery to treat carpal tunnel syndrome. Carpal tunnel syndrome is pain and weakness in the hand that is caused by pressure on the median nerve in the wrist.
Description Return to top
The median nerve and the tendons that flex (or curl) your fingers go through a passage called the carpal tunnel in your wrist. This tunnel is narrow, so any swelling can pinch the nerve and cause pain. A thick ligament (tissue) just under your skin makes up the top of this tunnel.
First, you will receive anesthesia (numbing medicine) so that you will not feel pain during surgery. You will be awake but also receive medicines to make you relax.
In carpal tunnel release, the surgeon will cut through this ligament to make more space for the nerve and tendons.
Sometimes surgeons do this procedure using a tiny camera that is attached to a monitor. The surgeon inserts the camera into your wrist through a very small incision and looks at the monitor to see inside your wrist. This is called endoscopic surgery. The instrument used is called an endoscope.
Why the Procedure is Performed Return to top
Patients with symptoms of carpal tunnel syndrome usually try non-surgical treatments first. These are:
If none of these treatments help, some surgeons will test the electrical activity of the median nerve with an EMG. If the test shows that the problem is carpal tunnel syndrome, carpal tunnel release surgery may be recommended.
If the muscles in the hand and wrist are getting smaller because the nerve is being pinched, surgery will usually be done right away.
Risks Return to top
Risks of carpal tunnel release are:
Before the Procedure Return to top
Always tell your doctor or nurse what drugs you are taking, even drugs, supplements, or herbs you bought without a prescription.
After the Procedure Return to top
This surgery is done on an outpatient basis. You will not need to stay in the hospital.
After the surgery, your wrist will probably be in a splint or heavy bandage for about a week. After the splint or bandage is removed, you will begin motion exercises or a physical therapy program.
Outlook (Prognosis) Return to top
Carpal tunnel release decreases pain, nerve tingling, and numbness better, and restores muscle strength. Still, most people are helped by this surgery.
The length of your recovery will depend on how long you had symptoms before surgery and how badly damaged your median nerve is. If you had symptoms for a long time, you may not be completely free of symptoms after you recover.
References Return to top
Scholten RJ, Mink van der Molen A, Uitdehaag BM, Bouter LM, de Vet HC. Surgical treatment options for carpal tunnel syndrome. Cochrane Database Syst Rev. 2007;(4):CD003905.
Botte MJ. Controversies in carpal tunnel syndrome. Instr Course Lect. 2008;57:199-212.
Wright PE II. Carpal tunnel, ulnar tunnel, and stenosing tenosynovitis. In: Canale ST, Beatty JH, eds. Campbell's Operative Orthopaedics. 11th ed. Philadelphia, Pa: Mosby Elsevier; 2007:chap 73.Update Date: 2/3/2009 Updated by: C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Dept of Orthopaedic Surgery. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.