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Carpal Tunnel Release


Why is this procedure done?


Your median nerve runs from your lower arm into your hand. If this nerve is squeezed at the wrist area, you may feel pain. You may also have weakness, tingling, or numbness in your hand and wrist. Swelling in this area puts pressure on the nerve and causes the signs. This is called carpal tunnel syndrome. The carpal tunnel is the small area in your wrist that the median nerve runs through. A tough band of tissues called a ligament holds everything in place over the carpal tunnel. ‚  
Carpal tunnel syndrome is a very common health problem. It is most often caused by doing hand or wrist movements over and over. It can also be caused by using the lower arm muscles too much. Doctors often try different treatments. If these do not work, surgery may be needed. ‚  


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What will the results be?


Carpal tunnel release should lessen hand and wrist pain. It should help with numbness and tingling. After surgery, muscle strength and the ability to use your hand should improve. ‚  

What happens before the procedure?


  • Your doctor will do an exam and take your history. Talk to the doctor about:
    • All the drugs you are taking. Be sure to include all prescription and over-the-counter (OTC) drugs, and herbal supplements. Tell the doctor about any drug allergy. Bring a list of drugs you take with you.
    • Any bleeding problems. Be sure to tell your doctor if you are taking any drugs that may cause bleeding. Some of these are Coumadin ‚ ®, ibuprofen, Aleve ‚ ® (naproxen), or aspirin. Certain vitamins and herbs, such as garlic and fish oil, may also add to the risk for bleeding. You may need to stop these drugs as well. Talk to your doctor about them.
    • If you need to stop eating or drinking before your procedure.
  • You will not be allowed to drive right away after the procedure. Ask a family member or a friend to drive you home.

What happens during the procedure?


  • Once you are in the operating room, you will be given a drug to make you sleepy. It will also help you stay pain free during the surgery. The staff will put an I.V. in your arm to give you fluids and drugs.
  • For open surgery:
    • Your doctor will make a small cut on the palm of your hand near the wrist. The doctor will then cut the ligament at the top of your carpal tunnel to take the pressure off the nerve. Sometimes, your doctor will take tissue out of the wrist to make the carpal tunnel bigger. Your doctor will use stitches to close the cut and put on a bandage.
  • For endoscopic surgery:
    • Your doctor will make two small cuts on the palm of your hand near the wrist. The doctor will then put a tiny camera into a cut. The doctor will put other small tools into the other cut. These tools will cut through the ligament at the top of the carpal tunnel. After the doctor removes the tools, the tiny cuts will be closed with stitches. Your doctor will put a bandage over the cuts.
  • The procedure takes about 15 minutes to 1 hour.

What happens after the procedure?


  • You will be taken to a Recovery Room where nurses and the staff will watch you for a while after the surgery.
  • You may go home the same day of your operation. It is very rare for your doctor to have you stay in the hospital overnight.
  • Your doctor may put on a splint or heavy bandage to cover the wound and keep the wrist still. Your doctor will tell you when you can take this off.

What care is needed at home?


  • Ask your doctor what you need to do when you go home. Make sure you ask questions if you do not understand what the doctor says. This way you will know what you need to do.
  • Use pillows to prop up your wrist. This will help with swelling.
  • Place an ice pack or a bag of frozen peas wrapped in a towel over the painful part. Never put ice right on the skin. Do not leave the ice on more than 10 to 15 minutes at a time. You can do this a few times a day.
  • Keep your splint in place. This will keep your wrist from moving.
  • Talk to your doctor about how to care for your cut site. Ask your doctor about:
    • When you should change your bandages
    • When you may take a bath or shower
    • If you need to be careful with lifting things over 10 pounds
    • When you may go back to your normal activities like work and driving
  • Be sure to wash your hands before touching your wound or dressing.

What follow-up care is needed?


  • Your doctor may ask you to make visits to the office to check on your progress. Be sure to keep these visits.
  • If you have stitches or staples, you will need to have them taken out. Your doctor will often want to do this in 1 to 2 weeks.
  • Your doctor may send you to physical therapy (PT). The PT will teach you exercises to help you get back your strength and motion.

What lifestyle changes are needed?


  • Avoid doing repetitive movements with your wrist and hand, if possible. If you have to do repeat movements, take rest breaks often.
  • If you sit at a computer, make sure your keyboard, mouse, desk, and chair are in the right positions so you do not put stress on the wrist. Think about using a special mouse and keyboard that are made to protect your wrist and hand.
  • If you have an assembly job, try alternating tasks, if possible.
  • Avoid holding your wrist and hand in the same position for too long.

What problems could happen?


  • Infection
  • Bleeding
  • Nerve injury
  • Ongoing wrist pain
  • Carpal tunnel syndrome returns

When do I need to call the doctor?


  • Signs of a very bad reaction. These include wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; or swelling of face, lips, tongue, or throat. Go to the ER right away.
  • Signs of infection. These include a fever of 100.4 ‚ °F (38 ‚ °C) or higher, chills, wound that will not heal.
  • Signs of wound infection. These include swelling, redness, warmth around the wound; too much pain when touched; yellowish, greenish, or bloody discharge; foul smell coming from the cut site; cut site opens up.
  • More numbness in hand

Where can I learn more?


American Association of Neurological Surgeons ‚  
http://www.aans.org/Patient%20Information/Conditions%20and%20Treatments/Carpal%20Tunnel%20Syndrome.aspx ‚  
National Institute of Neurological Disorders and Stroke ‚  
http://www.ninds.nih.gov/disorders/carpal_tunnel/detail_carpal_tunnel.htm ‚  

Consumer Information Use and Disclaimer


This information is not specific medical advice and does not replace information you receive from your health care provider. This is only a brief summary of general information. It does NOT include all information about conditions, illnesses, injuries, tests, procedures, treatments, therapies, discharge instructions or life-style choices that may apply to you. You must talk with your health care provider for complete information about your health and treatment options. This information should not be used to decide whether or not to accept your health care providers advice, instructions or recommendations. Only your health care provider has the knowledge and training to provide advice that is right for you. ‚  

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