These answers cover common questions before and after carpal tunnel decompression. Your own recovery may vary, so please follow any individual advice given by your surgical team.
What do I do if I need longer off work?
If the Med3 (sick note) we provided has run out you should contact your own GP to extend it. We can also help if you have difficulties with that.
Can I leave my nail varnish or artificial nails on?
We would prefer it if you remove artificial nails and varnish well in advance of the surgery. However, you can leave them on, if there is a special/specific reason for that. However, we will use an antiseptic solution all over your hand and it is possible that the varnish or artificial nails may be damaged or even removed.
Can I keep my rings on?
No rings can remain in place during surgery, or for a few weeks after surgery until the swelling has completely settled.
I can’t remove my rings, they’ve never been off, can’t I just leave them on?
No. Leaving rings that will not come off is dangerous. All hands swell after surgery and if the rings are that tight, the circulation to the fingers could be lost when the fingers swell post operatively. If the rings cannot come off, you must have them cut off before you attend or we may not be able to perform your surgery.
I am still in pain, what can I take?
Please see the Anaesthetic and Pain Relief in the aftercare area.
Pain in the first 48 hours is best controlled with paracetamol or co-codamol provided you have no reason to not take them.
Pain after the first 48 hours can include ibuprofen (provided safe for you to take) in addition to the paracetamol or co-codamol above.
If the mild co-codamol and ibuprofen is not enough to control the pain then you may need prescription strength co-codamol or other strong pain killers. You will need to see your GP or contact us for these.
My fingers are still numb
Please see the Persisting altered sensation or pain in the hand section on the aftercare page.
Initially, immediately after the surgery the anaesthetic may still affect the nerves and this numbness can last for several hours and even maybe a day or two. Beyond that some need longer for the nerves to recover and it can take several weeks for the symptoms to resolve.
In some cases swelling at the surgical site can lead to ongoing pressure on the nerves and this can lead to ongoing symptoms. Swelling can last 6 months or more and in some cases longer. Elevation and exercising of the hand and fingers can help reduce the swelling and speed recovery.
If you have persisting symptoms please contact us.
How long should I expect to be off work?
For desk-based or clerical work, many people need around 2–4 weeks away from work. Heavy manual work, heavy lifting or very hand-intensive work commonly needs around 6–8 weeks. These are guides rather than fixed rules: your symptoms, wound healing and the exact demands of your job may mean you return sooner or need longer.
What is pillar pain?
Pillar pain is tenderness or aching around the heel of the palm on either side of the operation area. It is a recognised part of recovery and occurs in around 10–15% of patients. It usually improves gradually with time as the tissues settle.
How long can the hand take to fully settle?
The wound itself heals much sooner, but swelling, scar sensitivity, tenderness and deeper tissue healing can continue to improve for many months. In some patients the hand can continue settling for up to 24 months.
What are the important risks of carpal tunnel surgery?
Recognised risks include infection, bleeding and nerve injury. Complex regional pain syndrome (CRPS) is rare. Pillar pain or tenderness around the heel of the palm occurs in around 10–15% of patients. Your own risks and expected benefit will be discussed with you as part of the consent process.
When should I contact you urgently after surgery?
Please seek advice promptly if you develop increasing redness, heat, marked swelling, pus or offensive discharge, fever or feel unwell; if bleeding does not stop with firm pressure and elevation; if the fingers become unusually pale, blue or cold; or if pain is severe and worsening rather than gradually settling. If you cannot contact us and the problem is urgent, use NHS 111 or the appropriate urgent or emergency service.
Will I need physiotherapy?
Most patients are encouraged to move the fingers regularly from the start and do not need formal physiotherapy. If you cannot make a full fist within about two weeks, movement remains very restricted or symptoms are disabling, please contact us because physiotherapy or further assessment may be helpful.