Carpal tunnel syndrome is pressure on the median nerve at the wrist, causing numbness, tingling, pain and weakness in the thumb, index, middle and part of the ring finger. Mild cases improve with splints or injections; persistent cases are treated by carpal tunnel release, a short day-case operation that divides the tight ligament.
- AnaesthesiaUsually local
- DurationTypically 15 to 30 minutes
- Hospital stayDay care
- Back to routineDesk work often in 1 to 2 weeks; heavy manual work after several weeks
What is carpal tunnel syndrome and carpal tunnel release?
Carpal tunnel syndrome (CTS) causes pain, numbness, tingling and weakness in the hand and arm. It usually results from pressure on the median nerve as it passes through the carpal tunnel at the wrist. This nerve controls sensation and some movement in the thumb, index, middle and part of the ring finger. Fluid retention and repetitive wrist movements can contribute.
Non-surgical care comes first for most people: activity modification, anti-inflammatory medication, wrist splints for mild to moderate symptoms, and corticosteroid injections for temporary relief while a longer-term plan is made. Injections are not suitable for prolonged use.
Carpal tunnel release cuts the transverse carpal ligament that forms the roof of the tunnel, relieving pressure on the nerve. Surgery generally gives better results than non-surgical care at one year, and a splint is not usually needed afterwards.
Who is carpal tunnel syndrome and carpal tunnel release for?
- Little improvement after several weeks of non-surgical treatment
- Persistent numbness or loss of hand coordination
- Weakness or wasting of the thumb muscles
- Pain or tingling that significantly disturbs sleep or daily activities
- Evidence of median nerve damage on examination or nerve conduction tests
- Underlying conditions such as arthritis that make spontaneous improvement less likely
How is it done?
- Usually performed as a day case under local anaesthesia
- Open release: a small incision of up to about 5 cm (2 inches) at the wrist and palm; the ligament is divided and the wound stitched
- Endoscopic release: one or two small incisions of about 1 cm through which a camera and fine instruments divide the ligament
- Open release has a slightly lower complication risk but a larger scar; endoscopic release usually means faster recovery and less pain but is not suitable for every case
- Before surgery: stop aspirin-type medicines about two weeks before if advised, disclose all medicines and supplements, report any illness, and follow fasting instructions
What is recovery like?
- Usually home the same day
- Stitches are typically removed at a review 10 to 14 days after surgery
- Use the hand lightly for everyday tasks; heavy gripping is usually limited for up to three months
- Physiotherapy or hand exercises are recommended before returning to manual work
- Tingling often improves quickly, while long-standing numbness or weakness may take months to recover
What are the risks?
- Bleeding or infection
- Nerve injury
- Stiffness and tender scar (pillar pain)
- Temporary reduction in grip or wrist strength
- Allergic reaction to anaesthetic or pain medicines; a small chance of symptoms persisting or returning
Why choose Dr. Jithendran?
- Dual training in orthopaedics (MS) and plastic surgery (MCh, DNB), with hand and microsurgery experience from Ganga Hospital, Coimbatore
- Consults at five hospitals across Bengaluru, with 24×7 availability for emergencies
- Clear explanations in English, Tamil, Hindi and Telugu, and time to answer every question
- Strict sterilisation and patient-privacy standards
Frequently asked questions
What are the early signs of carpal tunnel syndrome?
Common early signs are tingling or numbness in the thumb, index, middle and ring fingers, often worse at night or when holding a phone or steering wheel. People may wake up shaking the hand. Later, grip can weaken and objects may slip from the hand.
Can carpal tunnel syndrome be treated without surgery?
Yes, especially when symptoms are mild. Activity changes, anti-inflammatory medicines, night splints and steroid injections can relieve symptoms. Injections tend to give temporary relief. If symptoms persist after several weeks, or there is constant numbness or thumb weakness, surgery is usually recommended.
Is open or endoscopic carpal tunnel release better?
Both divide the same ligament. Open release has a slightly lower complication rate but a larger scar and somewhat longer recovery. Endoscopic release usually means less pain and a faster return to activities, but carries a slightly higher chance of needing further surgery and is not suitable for everyone. The surgeon advises based on your hand.
Is carpal tunnel surgery done under general anaesthesia?
Usually not. Carpal tunnel release is typically performed under local anaesthesia as a day case, so you are awake but the hand is numb. You normally go home the same day with a light dressing.
How long does recovery take after carpal tunnel release?
Stitches are usually removed after 10 to 14 days. Light use of the hand is encouraged early, but heavy gripping is often limited for up to three months. Night-time tingling frequently improves soon after surgery, while long-standing numbness may take several months.
