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About the procedure Carpal Tunnel Release

Our Philosophy on Carpal Tunnel Release

At AR Plastic Surgery, carpal tunnel release is offered to patients experiencing persistent symptoms of carpal tunnel syndrome, a condition caused by pressure on the median nerve as it passes through the wrist. This nerve controls feeling and movement in parts of the hand and fingers. When compressed, it can lead to pain, tingling, numbness, and weakness in the hand.

Carpal tunnel release is considered when non-surgical treatments such as splinting, rest, or injections do not relieve symptoms, or when nerve compression is severe. The procedure involves dividing the transverse carpal ligament—the structure pressing on the nerve—to relieve pressure on the median nerve. This can help reduce discomfort and limit the risk of ongoing nerve damage.

Each case is assessed individually, with a focus on understanding the patient’s symptoms, functional goals, and overall health. During the consultation, we explain the potential benefits and risks of surgery, outline the steps of the procedure, and discuss the expected recovery process. Our aim is to support informed decision-making and provide care that aligns with the patient’s needs and hand function requirements.

Understanding Carpal Tunnel Syndrome

Carpal tunnel syndrome occurs when the median nerve is compressed within a narrow space in the wrist called the carpal tunnel. This space also contains tendons that help bend the fingers. Swelling or thickening in this area due to overuse, injury, arthritis, or fluid retention can increase pressure on the nerve.

Common symptoms include numbness or tingling in the thumb, index, and middle fingers, especially at night or with repetitive hand movements. Some patients experience hand weakness, clumsiness, or a tendency to drop objects. In more advanced cases, there may be noticeable muscle wasting at the base of the thumb, which can impact fine motor function.

Diagnosis is based on clinical history, physical examination, and, if needed, tests such as nerve conduction studies or ultrasound. These tests assess the health and function of the median nerve and help determine whether surgery is necessary. Early diagnosis and treatment can prevent further nerve damage and improve long-term outcomes.

Non-Surgical Management

Initial treatment for mild to moderate carpal tunnel syndrome often involves non-surgical options. These may include wrist splinting, especially at night, to keep the wrist in a neutral position and reduce nerve pressure. Activity modification is also important to limit repetitive or forceful hand movements that may worsen symptoms.

Anti-inflammatory medications or corticosteroid injections may help reduce swelling in the carpal tunnel and relieve symptoms temporarily. Hand therapy may be recommended to strengthen surrounding muscles and improve wrist posture during daily tasks. In some cases, changes in ergonomics at work or home may reduce strain on the wrist.

While non-surgical measures can help manage symptoms, they are less likely to provide lasting relief when the condition is severe or long-standing. Patients who continue to experience pain, numbness, or weakness despite these treatments may be suitable candidates for surgery. The decision is based on symptom severity, nerve test results, and how the condition affects daily activities.

Who May Consider Carpal Tunnel Release

Surgery may be recommended when symptoms do not respond to conservative treatments such as splinting, rest, or corticosteroid injections. Patients who experience ongoing numbness, hand weakness, disrupted sleep, or difficulty performing routine tasks like writing or gripping may benefit from surgical treatment. In general, the procedure is most effective when carried out before long-standing nerve compression causes permanent changes.

Some patients may postpone surgery due to other health concerns, pregnancy, or the demands of work or caregiving. In these situations, non-surgical management is adjusted based on the patient’s condition and closely monitored over time. Surgery is usually considered when symptoms start interfering with daily life or when test results show progressive nerve involvement.

The decision to have surgery is made in partnership with the patient, based on a clear understanding of their symptoms and goals. Patients are encouraged to ask questions and take time to consider their options. At AR Plastic Surgery, we support each patient with clear information and ongoing guidance throughout the decision-making process.

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What to Expect on the Day of the Procedure

Carpal tunnel release is performed under local or regional anaesthesia, sometimes with light sedation depending on the individual case. On arrival, patients are admitted to the surgical facility, and the affected hand is clearly marked. The anaesthesia method is confirmed, and final checks are completed before the procedure begins.

A small incision is made in the palm or wrist to access the carpal tunnel. The transverse carpal ligament, which is pressing on the median nerve, is carefully divided to relieve pressure. The nerve is protected during the procedure, and any surrounding thickened tissue or scarring may also be addressed if present.

After the procedure, patients are taken to a recovery area where their condition is monitored before discharge. They are given clear instructions on how to care for the wound, keep the hand elevated, and avoid activities that may place stress on the area. A follow-up appointment is arranged to check healing and remove sutures if required.

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Disclaimer: The outcomes shown are only relevant for this patient and do not necessarily reflect the results other patients may experience, as results may vary due to many factors, including the individual’s genetics, diet and exercise. Some images may have the patient’s tattoos, jewellery or other identifiable items blurred to protect patient identities.

Aftercare and Recovery

Recovery following carpal tunnel release varies depending on the extent of nerve compression and the individual’s healing response. Some patients notice reduced symptoms within a few days, particularly relief from night-time numbness. For others, recovery may take several weeks as sensation and hand function gradually return.

Patients are advised to keep the hand elevated above heart level in the first few days to reduce swelling. Ice packs may also be used to relieve discomfort. Gentle finger movement is encouraged early to reduce stiffness, but heavy lifting or repetitive hand use should be avoided until advised otherwise.

The incision site may remain sensitive for a few weeks, and scar massage may be suggested once the wound has healed. Hand therapy may be arranged if stiffness or weakness persists. Patients can return to light activities within 1 to 2 weeks and resume full activities after 4 to 6 weeks, depending on the nature of their work and recovery progress.

Potential Risks

As with any surgery, carpal tunnel release carries some risks. These are discussed during the consultation, and patients are provided with clear information to support informed consent. Potential risks include:

  • Infection
  • Bleeding or haematoma
  • Haematoma (collection of blood)
  • Scar sensitivity or tenderness
  • Stiffness or reduced grip strength
  • Incomplete relief of symptoms
  • Injury to nerves or blood vessels
  • Recurrence of symptoms over time
  • Delayed wound healing

Patients are encouraged to contact the clinic promptly if they have any concerns during their recovery. A clear follow-up plan is provided, and the team remains available to offer guidance and support throughout the healing process. Ongoing communication helps ensure any issues are addressed in a timely manner.

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