Carpal tunnel and other nerve compression surgery

Finding the cause of numbness and weakness

Carpal tunnel release

Carpal tunnel syndrome involves compression of the median nerve at the wrist. Splinting and other nonoperative treatment may help selected patients. Surgery releases the ligament forming the roof of the tunnel to reduce pressure on the nerve.

Night tingling may improve earlier than constant numbness or weakness. Severe or longstanding nerve damage may not recover completely, even after adequate release. We discuss this before surgery so the expected benefit is realistic.

Cubital tunnel and other compression sites

Ulnar nerve compression at the elbow can affect sensation in the little finger and part of the ring finger and weaken small muscles in the hand. Treatment depends on severity, nerve stability and the underlying cause. An operation may involve decompression and, in selected cases, relocation of the nerve. Other suspected compression sites require their own assessment; a wrist release will not treat every cause of hand numbness.

Recovery and work

Wound healing, scar tenderness and nerve recovery follow different timescales. Modified duties may be possible before strength or sensation has recovered. Heavy gripping, repetitive loading and driving require individual advice. Risks include bleeding, infection, nerve injury, persistent or recurrent symptoms, tenderness, stiffness and further surgery. Longstanding weakness may require a separate discussion about reconstructive options.

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