Carpal tunnel decompression is an operation to relieve pressure on the median nerve as it passes through the carpal tunnel at the wrist. In our community service it is normally carried out under local anaesthetic, so you are awake but the hand and wrist are numbed.
What happens during the operation?
1. Local anaesthetic
Local anaesthetic is given around the operation area. You may still be aware of pressure, movement or touch, but you should not feel sharp pain. Tell the surgical team if you are uncomfortable at any stage.
2. A small incision is made
A small incision is made in the palm and wrist area. The exact position and length can vary slightly according to your anatomy and the surgeon’s assessment.
3. The median nerve is released
The ligament forming the roof of the carpal tunnel is carefully divided. This creates more space in the tunnel and releases the pressure on the median nerve.
4. The wound is closed and dressed
Once the decompression is complete, the wound is closed with stitches and a dressing and bandage are applied. The type of stitch may vary and your team will explain what has been used.
5. You go home the same day
You will normally go home after the procedure. Light use of the hand and regular finger movement are encouraged, while elevation is particularly important during the first 48 hours. Follow the detailed aftercare instructions you are given.
What improvement should I expect?
The aim is to reduce symptoms caused by pressure on the median nerve, such as tingling, numbness, night symptoms and pain. Some people notice improvement quickly, while recovery can be gradual when the nerve has been compressed for a long time.
Recognised risks and recovery
Recognised risks include infection, bleeding and nerve injury. Complex regional pain syndrome (CRPS) is rare. Some people develop tenderness or aching around the heel of the palm, often called pillar pain; this occurs in around 10–15% of patients and usually settles gradually. Scar sensitivity, swelling and deeper tissue healing can continue to improve for many months, and in some people the hand may continue settling for up to 24 months.
Your individual risks, likely benefit and alternatives will be discussed with you as part of your consultation and consent process.