Carpal tunnel syndrome (CTS) impacts hand and wrist function. People with mild or moderate carpal tunnel may respond to nonsurgical treatment, whereas severe cases may require surgery.

Carpal tunnel is a common problem that impacts the median nerve in the wrist. Inflammation around this nerve can lead to discomfort in the hands and impair function and movement.

Treatment options such as wrist splinting and exercises aim to slow the progression of CTS. However, some people may need carpal tunnel release surgery to prevent symptoms from reoccurring.

This article examines this surgical procedure in detail, some of the most common risks, the recovery, and what people can expect.

CTS may worsen without treatment. Symptoms include:

  • weakness or numbness in the hands
  • painful or tingling sensations that stretch up the forearm
  • tingling in the fingers
  • the feeling of small shocks in the hands

As the condition worsens, symptoms may occur more frequently or persist for longer periods.

When people experience symptoms, a doctor will typically recommend nonsurgical treatments. These can include physical therapy and splints.

Doctors will also prescribe non-steroidal anti-inflammatory drugs to reduce swelling, such as aspirin or ibuprofen. They may also recommend steroid injections in the carpal tunnel to calm a flare-up of CTS. The results of the injections tend to last temporarily.

Learn more about other ways to reduce discomfort from CTS at home.

If nonsurgical approaches do not help, a doctor may advise surgery. Carpal tunnel surgery can help relieve symptoms. As with any surgery, it does come with certain risks. A medical professional can determine whether carpal tunnel surgery is the most appropriate treatment for a person.

Doctors recommend a surgical procedure if people have particularly severe symptoms and other treatments have not successfully relieved pain.

Carpal tunnel surgery decreases the amount of pressure placed on the median nerve. We explore questions about this procedure in detail below.

What is open release surgery?

Carpal tunnel release — also called carpal tunnel decompression — is one of the most common surgical procedures in the United States.

Open release surgery involves doctors making a small incision on the inside of the wrist. Doctors will then cut through the flexor retinaculum, the transverse carpal ligament. Dividing the ligament widens the carpal tunnel, releases pressure, and eases symptoms.

Surgeons may also perform another type of surgery: endoscopic carpal tunnel release. This surgery involves making two smaller incisions in the wrist and allows the surgeon to work with a camera. This approach is less invasive and can speed recovery.

How long does the procedure take?

The timing for each specific procedure will vary depending on the doctor and the severity of the person’s symptoms. In many cases, it will take less than an hour.

Surgery may take longer in more advanced or complicated cases. However, most people undergoing carpal tunnel surgery will not experience a long or complex procedure.

Where does carpal tunnel surgery take place?

Carpal tunnel surgery typically takes place in an outpatient or day clinic.

In many cases, individuals undergoing this surgery will have a local anesthetic to avoid discomfort during the procedure.

One of the most common risks with carpal tunnel surgery is losing grip strength. Most people may have a weaker grip on their affected hand, but this tends to improve over time.

Many individuals will experience numbness or weakness following the procedure. Other risks associated with carpal tunnel surgery include:

  • pain around the scar areas
  • damage to the nerves
  • infections
  • stiffness in the hands and wrists

In rare cases, a person may experience a recurrence of carpal tunnel symptoms after surgery. Generally, most people do not experience this or other severe side effects from this surgical procedure.

Any individual considering surgery for carpal tunnel should speak with their doctor about possible risks. Every surgery is different, and risk levels are different for everyone. Only a medical professional can provide accurate advice about each person’s risks.

The healing and recovery process depends on the individual and the surgical procedure. People who experience surgery without complications can expect to recover within a few weeks.

Immediately after surgery

There may be some pain or soreness around the operation site for a few weeks. This soreness typically resolves around 6 weeks but can occasionally last a few months. A doctor may prescribe pain medications to help. People can often manage pain at home by elevating the hand and taking over-the-counter painkillers, such as ibuprofen.

Doctors do not recommend lifting anything heavy right after surgery. People should elevate their hands for a few days after surgery as much as possible. Any dressings covering the surgical site should also be kept clean and dry.

Long-term recovery

After the initial recovery, doctors recommend using the hand and wrist for day-to-day activities. Keeping the fingers moving can help prevent stiffness and swelling.

Individuals may experience weakness in their hands following carpal tunnel surgery. This weakness is expected, and many people regain hand strength over time. Physical therapy exercises can help to improve grip strength.

Most individuals will experience a full recovery between 6 weeks and 3 months. The recovery period depends on the person’s overall health and the severity of CTS before the surgery.

A physical therapist can recommend the best exercise program for each person recovering from carpal tunnel surgery. Recovery exercises can improve strength, reduce pain, and speed healing.

Some common exercises involve wrist range of motion. These start with the forearm resting on a table or desk with the thumb facing up. Moving the palm up, down, and to each side can increase the range of motion and flexibility.

Physical therapists may also recommend scar desensitization or mobilization exercises. Gently massaging scarred areas after surgery can stretch scar tissue and improve sensation in these areas.

Anyone recovering from carpal tunnel surgery should follow the exercises for at least 6–8 weeks to help prevent symptoms from returning.

The general success rate for carpal tunnel surgery is high. One study showed that between 75–90% of surgeries successfully treated carpal tunnel.

Open release surgery reduces pressure on the median nerve. The surgery helps to reduce the pain or tingling sensation through the hands and wrists. Surgery can also prevent atrophy, the wasting of nerves and muscles, in the advanced stages of carpal tunnel.

The rates of serious complications from carpal tunnel surgery are very low. Most researchers agree that this surgery is a safe option for most people.

Results will vary according to each person’s overall health and lifestyle factors such as activity and diet. It may also depend on a person’s age. For example, older individuals tend to report less satisfaction with the results of carpal tunnel surgery. This dissatisfaction may be due to the slowing of nerve regeneration during the aging process.

People with carpal tunnel should review expected results with their surgeon before the operation. Outcomes vary depending on the individual case, but most people report positive results.

For mild or moderate cases of CTS, doctors often recommend nonsurgical treatment approaches. However, in advanced cases, carpal tunnel surgery may be necessary.

Carpal tunnel surgery is typically a quick, low-risk procedure. Most people who have this surgery do not experience significant complications. Carpal tunnel symptoms generally improve after surgery, and full recovery is possible within a few months.

Individuals with CTS should consult a medical professional to determine the most suitable treatment program.