Carpal Tunnel Release; what is involved & what to expect afterwards

Operative Carpal Tunnel Release is the procedure used to relieve the symptoms of Carpal Tunnel Syndrome, that is releasing pressure on the median nerve at the level of the wrist. There are two types of surgery commonly performed; endoscopic and open. Both procedures involve cutting the roof of the carpal tunnel, the Transverse Ligament.

Endoscopic Release
During Endoscopic surgery the surgeon sees and releases the ligament through a tube which is inserted through a small incision. Following the procedure clients are rarely referred for hand therapy.

Open Carpal Tunnel Release
Open Carpal Tunnel surgery involves release of the ligament through an incision at the wrist. Open Carpal Tunnel release is especially effective where there is a build up of synovitis or thick fluid or scarring in the carpal tunnel. The open approach allows the surgeon adequate access to the synovitis, such that s/he can remove it.

After your Open Carpal Tunnel Release
Following this open technique you may wake to find your hand heavily bandaged up, and you may not be able to move your wrist much in these heavy dressings.
Stitches are usually removed 10-14 days after the operation. Some people find that their wound opens up in the days following the operation. It is best to discuss this with your surgeon or his/her nurse. If there is no infection present, some wound opening is not usually a concern. Your surgeon, nurse or hand therapist can help to assess and manage wounds.
Some people may notice bruising in their palm, this is not usually anything to be concerned about, gently massaging over the bruise may help to settle it.
Swelling is also not uncommon after an operation. Hand Therapy can help to manage swelling. Seeking hand therapy assistance early can help get on top of the symptoms early and get you back to using your hand in a timely fashion. 
Wrist stiffness is also expected when you have been bandaged up. But if stiffness is present in the fingers, thumb, elbow or persists in the wrist- it is recommended you see a hand therapist for assessment of this and advice on how to regain movement.
As our hands play such an important role in performing everyday tasks, and many people require the use of their hands for work and hobbies, it can be daunting knowing when is the best time to get back to safely doing certain activities. Our Hand Therapists can help you to regain strength and advise on what tasks are safe to and best to avoid at different time frames following your operation.
We can also discuss strategies that can help when you return to work tasks and hobbies which require forceful gripping. We can look at adapting tools, use of specific gloves or splints, and altering the way your body is positioned or moves in specific activities to best protect the operation site. Some people find that they continue to use the strategies they adopt following carpal tunnel release, because they may help reduce recurrence.

Carpal Tunnel Release is a relatively common operation, and recovery is usually relatively smooth and straightforward. But if you require a helping hand getting back to doing the things that you most enjoy, a hand therapist can help get you back on track quickly.