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  • Q&A with Australian Health Practitioners

    What are the side effects of surgery for carpal tunnel syndrome?

    I am scheduled to have surgery in two weeks for my carpal tunnel syndrome. How will this affect me afterward? Will I still feel pain?
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    Ryan Hislop is the Clinical Director at the Orange Chiropractic Health and Wellness Centre. As an experienced and evidence-based diagnostician, Ryan works largely by medical … View Profile

    Carpal tunnel surgery is one of the most common surgical procedures in Australia and is generally recommended if symptoms last for mroe than 6 months. 

    Due to the nature of both open release and endoscopic surgery there are a few complications that may result directly from the surgery. Some patients may have infection, nerve damage, joint stiffness, pain at the scar. There is occasionally a loss of strength at the wrist as the carpal ligament is cut. 

    Research has found that 90% of patients are able to return to their same jobs after surgery. They also found that in general, endoscopic techniques are as effective as open carpal surgeries although there is a faster recovery time with endoscopic procedures. This is felt to be offset by the higher complication rates associated with endoscopic surgery. 

    • Schmelzer, Rodney E.; Rocca, Gregory J. Della; Caplin, David A. (2006). “Endoscopic Carpal Tunnel Release: A Review of 753 Cases in 486 Patients”. Plastic and Reconstructive Surgery 117 (1): 177–85.
    • Quaglietta, Paolo; Corriero, G. (2005). Endoscopic carpal tunnel release surgery: retrospective study of 390 consecutive cases. “Advanced Peripheral Nerve Surgery and Minimal Invasive Spinal Surgery”. Acta Neurochirurgica Supplementum. Acta Neurochirurgica 97: 41–5. 
    • Park, S.-H.; Cho, B. H.; Ryu, K. S.; Cho, B. M.; Oh, S. M.; Park, D. S. (2004). “Surgical Outcome of Endoscopic Carpal Tunnel Release in 100 Patients with Carpal Tunnel Syndrome”. Minimally Invasive Neurosurgery 47(5): 261–5. 
    •  Scholten, R; Bouter, LM; Gerritsen, A; Uitdehaag, BM; De Vet, HCW; Van Geldere, D; Scholten, Rob (2004).Surgical treatment options for carpal tunnel syndrome. In Scholten, Rob. “The Cochrane Database of Systematic Reviews”. Cochrane Database of Systematic Reviews.
    • McNally, S. A.; Hales, PF (2003). “Results of 1245 endoscopic carpal tunnel decompressions”. Hand Surgery 8 (1): 111–6. 
    • Thoma, Achilleas; Veltri, Karen; Haines, Ted; Duku, Eric (2004). “A Meta-Analysis of Randomized Controlled Trials Comparing Endoscopic and Open Carpal Tunnel Decompression”. Plastic and Reconstructive Surgery: 1137–46. 
    • ^ Chow, J; Hantes, M (2002). “Endoscopic carpal tunnel release: Thirteen years' experience with the chow technique”. The Journal of Hand Surgery 27 (6): 1011–8. 

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    Ryan Hislop is the Clinical Director at the Orange Chiropractic Health and Wellness Centre. As an experienced and evidence-based diagnostician, Ryan works largely by medical … View Profile

    In terms of post operative discomfort, the patients that I have referred for the surgery have had slight soreness at the incision site for a few weeks followed by a gradual reduction in local symptoms over the following months. 
    Prognosis differed from person to person depending on how long the compression of the nerve has been there and a few other co factors. It is best to talk to your specialist about this. 

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    Dr Jill Tomlinson is a fully qualified plastic, reconstructive and hand surgeon. After graduating dux in her year at University High School, Jill completed medical … View Profile

    Most people undergoing carpal tunnel surgery experience pain prior to surgery because it is one of the symptoms of carpal tunnel syndrome. Your question doesn't say how much this pain is troubling you but the good news is that the pain from nerve compression in carpal tunnel syndrome is immediately relieved with successful surgery.

    The other common symptom of carpal tunnel syndrome is numbness and tingling of the fingers. This resolves quickly in some people after surgery but in others it can weeks to months to improve fully. This is because the nerve may take time to recover after it has been compressed. People who have had very severe carpal tunnel syndrome may never recover full sensation, even after successful surgery.

    As for post operative recovery, I definitely recommend that you discuss this with your surgeon. One of the most important factors is what you do with your hands (your occupation) - I give different advice to boilermakers than I do to office workers as the demands that each individual places on their hands are quite different. At the time of surgery local anaesthetic will be used to minimise any pain you experience in the first day. When the local anaesthetic wears off most people find that simple pain killers (like over the counter analgesics) are sufficient to keep them comfortable. It is important to keep your hand elevated at or above the level of your heart to reduce swelling and pain. Office workers may wish to take 2-7 days off work, depending on the demands of their job and their amount of sick leave. Boilermakers may need 6 weeks off work, depending on the availability of light duties and the speed of their individual recovery.

    Thank you for your question and I hope your surgery and postoperative recovery goes smoothly!

    For more information about carpal tunnel syndrome and other conditions of the hand and wrist please visit the Melbourne Hand Surgery website.

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