Carpal Tunnel Decompression

If you have been diagnosed with Carpal Tunnel Syndrome (CTS) then one option to get rid of it is surgery. Usually other, simpler, treatments will have been tried before you get to surgery: steroid injections and wearing splints at night. If those haven’t helped or have stopped working then an operation would be the next step.

I’ve been told I will be out of action for 12 weeks after the surgery.

I hear this a lot and it’s simply not the case. Let me walk you through the procedure so you know the realities of what is going to happen.

The surgery is almost always done under local anaesthetic and it takes less than 10 minutes so you will be in and out of hospital within an hour or so.

So, when you arrive at hospital (usually pretty early because I like to do these smaller cases first) you will be taken up to your room and made comfortable. You don’t need to change into the famous backless hospital surgical gown you will be pleased to hear. I will come and say hello and put a marker pen arrow on the arm we are dealing with. Then you will be walked down to the operating theatre and up onto the operating table where you will be laid flat. There is a lot of hustle and bustle in theatres (plus my noisy music and maybe even some tuneless singing!) but someone will be with you all the time and we will keep explaining what we are doing.

Does the local anaesthetic injection hurt?

Yes of course it will – its an injection. But the pain only lasts for a few seconds. Remember only the palm goes to sleep so don’t be anxious if you can still feel your fingers. That’s normal. Then one of the team will put a tourniquet round your upper arm (like having your blood pressure taken) and squeeze all the blood out of your arm and inflate the tourniquet. I’m afraid that does become quite uncomfortable but the procedure only takes 6-7 minutes so it will be over soon.

What do you do and can I watch?

You can if you want but only about 5% do.

The operation simply involves removing the roof from the (carpal) tunnel which is done through an incision about 1 inch long. Once I am happy that the retinaculum has been full divided and that there is no pressure on the nerve (decompressed) then I close the wound with 5 stitches (NOT dissolving ones) and put on the bandage.

Do I have to have a great big bandage?

No. The days of the boxing glove bandage have long gone and the one I use is pretty low profile and leaves your fingers and thumb free to use as normally as you can manage. You take it off yourself at home after 4 days and the stitches come out 10 days after the operation.

How do I manage to look after myself with the bandage on?

For those first 4 days you can keep the bandage clean and dry for showers/baths and bottom wiping by putting your hand in a large washing-up glove and using waterproof tape to seal it. Once the bandage comes off you just need an Elastoplast over the cut (it is about an inch long): use a waterproof one for baths and showers and a breathable one the rest of the time.

And what can I do? Drive? Use a keyboard?

You can drive as soon as you like and use your hand for normal day to day things. You won’t be able to push through the hand or grip too hard initially but it all comes back pretty quickly. However you will find it uncomfortable to push through the wrist for several months.

I’ve got CTS in both hands. Should I have them both operated on at the same time?

Yes. Get it over with in one go. It’s not much more of a problem to look after yourself afterwards and it’s just one recovery period, one time off work, and one time away from the golf course etc rather than two.

CTD (carpal tunnel decompression) is a very safe and very effective procedure and hopefully this section has given you an accurate idea of what it entails.