Hand Surgery

Carpal Tunnel Treatment

at Cadogan Clinic, London’s Leading Cosmetic Surgery Specialists. 

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Medically Reviewed December 2023, by Mr. Bryan Mayou (GMC: 1414396) - founder of the Cadogan Clinic and one of the world's leading plastic surgeons

What is carpal tunnel surgery?

Carpal tunnel release is a surgical treatment which cures carpal tunnel syndrome by cutting the ligament pressing on the median nerve, relieving the pressure on the nerve.

There are two different surgical methods used in carpal tunnel treatment - open surgery and endoscopic surgery, also known as keyhole surgery. Although both techniques involve cutting the ligament, the endoscopic method uses a small camera to see inside the carpal tunnel. This type of surgery involves smaller incisions than open surgery. This results in a faster, more comfortable, recovery. Your surgeon will discuss with you which method is best suited for you before going ahead with carpal tunnel surgery.

After carpal tunnel surgery, the cut ligament tissues gradually grow back together while allowing more room for the median nerve. This process typically takes several months.

Carpal tunnel surgery is the best option if the symptoms are particularly severe or they have not responded to previous treatment.  Surgery can successfully cure carpal tunnel syndrome.

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What is carpal tunnel syndrome?

The carpal tunnel is a narrow channel running along the hands and wrists. It houses the tendons used to bend the fingers and thumb, alongside the median nerve. Sometimes this nerve becomes compressed, which causes problems with the function of the hand, for example a weakness which means you may find it difficult to hold items. It can also cause a change in sensation, for example tingling or numbness. It may even be quite painful. This is carpal tunnel syndrome.

Carpal tunnel syndrome may affect one or both hands and varies in severity. People with the condition often find that the symptoms are worse at night and certain activities can trigger the symptoms during the day. Sometimes shaking the affected wrist or wrists or changing position can help to alleviate these symptoms.

Anyone can suffer from carpal tunnel syndrome, but it is more common in women and tends to develop in people aged between 50 to 54 and 75 to 84.

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What causes carpal tunnel syndrome?

Carpal tunnel syndrome is caused by pressure on the median nerve in the wrist. This nerve runs along the forearm through the carpal tunnel, but when this passageway swells, it squeezes this nerve, causing tingling, numbness or weakness in the hand and arm, known as carpal tunnel syndrome.

There are a number of things that put a person at a higher risk of developing carpal tunnel syndrome:

  • Previous wrist injury: If you have previously fractured or dislocated your wrist, this can alter the space in the carpal tunnel, adding pressure to the median nerve.
  • Pregnancy: Fluid retention during pregnancy may increase the pressure within the carpal tunnel, irritating the nerve. This usually gets better on its own after pregnancy.
  • Medical conditions: Some chronic illnesses, such as diabetes, increase the risk of damage to the median nerve, putting you at a heightened risk of carpal tunnel syndrome. People with inflammatory conditions, for example rheumatoid arthritis, find that these can affect the lining around the tendons in the wrist, putting pressure on the median nerve. Other medical conditions associated with developing carpal tunnel syndrome include thyroid disorders, kidney failure, menopause and lymphedema.
  • Family history: You are more likely to have carpal tunnel syndrome if you have a parent or sibling with the condition.
  • Work: Work which involves repeatedly bending your wrist or gripping tightly may lead to carpal tunnel syndrome.
  • Obesity: Being obese puts you at a higher risk of carpal tunnel syndrome.
  • Cysts or tumours: The presence of cysts or tumours in the carpal tunnel can cause pressure on the nerve.

What are the signs and symptoms?

Carpal tunnel syndrome symptoms range in severity from mild to severe. If you have carpal tunnel syndrome, you may experience one, some or all of the following symptoms.

  • Altered feeling in hand, usually felt in the thumb, index, middle and ring fingers. Some describe the feeling like an electric shock.
  • Feeling of an ‘electric shock’ travelling from the wrist up the arm.
  • Pain in the hands, wrist or forearm. This pain may be worse when holding an object or when the affected hand is elevated.
  • A tingling feeling which is usually worse at night or first thing in the morning
  • Swollen or ‘heavy’ feeling in the fingers
  • Failing to grasp objects and frequently dropping things
  • Weak pinch grip
  • Weakness and wasting of the muscles at the base of the thumb

In more mild cases of carpal tunnel syndrome, the symptoms may come and go. Over time any numb feeling may become constant.

If you have any of the signs or symptoms of carpal tunnel syndrome you should book an appointment with one of our expert surgeons here at the Cadogan Clinic to discuss carpal tunnel treatment in London.

How is carpal tunnel syndrome diagnosed?

To diagnose carpal tunnel syndrome, the doctor will examine your hand and wrist, testing the movement, feeling and strength. They will also use a test known as the Tinel’s test, which involves tapping over the tunnel, or Phalen’s test, which involves squashing the carpal tunnel.

They will ask you questions about your symptoms and medical history.

A blood sample may be taken to test for any inflammation or thyroid problems and occasionally a nerve conduction test is needed to find out how badly the nerve has been squashed.

Imaging scans, such as an MRI or ultrasound scan, are not usually required, but if the doctor is not sure it is carpal tunnel and suspects another condition, then they may require you to have further tests.

How does carpal tunnel surgery work?

Carpal tunnel surgery works by cutting the ligament which is pressing on the median nerve. This relieves the pressure on the nerve and successfully treats the symptoms of carpal tunnel syndrome. The ligament tissues gradually grow back after surgery, but this time leaving more room for the nerve.

There are two different surgical methods which may be used in carpal tunnel release.

In open carpal tunnel surgery, the surgeon will start by making an incision close to the bottom of the palm of your hand. They will then proceed to cut through the ligament, releasing the pressure on the median nerve. The hand is then stitched and bandaged. The operation is carried out using a local anaesthetic to numb the hand.

This method of carpal tunnel surgery sees the surgeon making two small cuts in the hand or wrist near the carpal tunnel. A medical instrument with a tiny camera attached, known as an endoscope, is inserted through these incisions. This camera gives the surgeon a good view of the inside of your hand and wrist. Using the camera as a guide, the surgeon will then use small surgical instruments to cut the carpal ligament, relieving the pressure on the nerve. This method is considerably less invasive than open carpal tunnel release and avoids causing damage to the skin and tissue sitting above the carpal tunnel. It often results in a quicker and more comfortable recovery. Keyhole surgery is also carried out under a local anaesthetic.

Both these carpal tunnel treatments are carried out at the Cadogan Clinic’s award-winning clinic as a day case, meaning that you can go home on the same day as your carpal tunnel release.


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The Patient Journey. A breakdown of what you can expect on your journey with us

We are deeply invested in ensuring that every step of your surgical journey with us is as informative and reassuring to you as it can be. This article outlines what you can expect at each stage of the journey

The Patient Journey

Frequently Asked Questions

Recovery from carpal tunnel release varies from person to person and depends on which type of surgery you have. But as a rule, it generally takes around three months to regain strength in the affected hand.

You can use your hand for ‘light duties’ in the first couple of days of surgery, for example holding a drinking glass or gently typing on a computer. You can gradually build up to other activities over the following six to 12 weeks.

With regards to time off work, this really depends on the type of job you do. If you have a desk job or a job that involves light duties, you may be able to return after two weeks, or perhaps even sooner. If you do a manual job, then you will need to take more time off to allow yourself to recover. Your surgeon will be able to advise you on how long you will need to take off.

It is very important that you follow all the aftercare advice issued by your surgeon. Failure to do so may impact on your recovery and the final result.

If you are experiencing pain or discomfort due to carpal tunnel syndrome, there are a number of things you can do to relieve this.

  • Take painkillers: Painkillers such as aspirin or ibuprofen can help with pain management, or your GP can prescribe something stronger if required.
  • Wear a wrist splint: Some people with carpal tunnel syndrome find that using a snug-fitting wrist splint to keep the wrist in a midline position may help with any pain or discomfort. Sometimes people find that wearing a splint overnight only is enough to help.
  • Make lifestyle changes: It’s important to limit activities that make your symptoms worse and avoid overusing the wrist when squeezing or gripping. Take more frequent breaks to rest your hands and wrists. Lose weight if you are obese to ease pressure on the median nerve.
  • Exercises: Stretch your wrists back or reach forwards as if pushing a door open, then reach upwards as if pushing the ceiling. Try this 10 times in a row, up to four times a day.
  • Seek treatment for underlying health conditions: If your carpal tunnel syndrome is caused by an underlying health condition, treating this may help to relieve your carpal tunnel syndrome.

Ultimately, the most effective way of ridding yourself of painful carpal tunnel syndrome is by surgery.

Yes, you can get carpal tunnel release on the NHS. However the NHS has been, and continues to be, hit hard by the Covid-19 pandemic. High levels of staff sickness have had an impact on waiting times across the board. These waiting times vary from hospital to hospital. You could potentially be facing weeks or even months of waiting for your carpal tunnel surgery on the NHS. And any new waves of Covid-19 infections may result in this wait getting even longer. Of course it is not the fault of the NHS, but if faced with a lengthy wait for treatment, you may find that your condition worsens. Because of this, many people choose to go to a private clinic for their carpal tunnel treatment. At the Cadogan Clinic, there is no waiting list, so providing you meet the criteria, you can have the procedure promptly.

Carpal tunnel surgery is not painful. A local anaesthetic is injected into the hand, so you will not be able to feel any pain during carpal tunnel release. However you may feel some pressure.

During the recovery process, you may experience a degree of discomfort or soreness. This should be easily controlled by taking over-the-counter painkillers.

As part of your carpal tunnel surgery at the Cadogan Clinic, you will receive comprehensive post-operative aftercare courtesy of our specialist team and 24/7 on-call nurse assistance during the recovery period.

If you have any concerns ahead of your carpal tunnel treatment, please speak to your surgeon who will be able to put your mind at rest.

It is possible for carpal tunnel syndrome to go away on its own, but this can take six months and it is less likely to happen if you are aged over 30. If left untreated, carpal tunnel syndrome can get worse, causing pain and impacting on the function of the affected hand and wrist. This can hamper your ability to perform day-to-day tasks and, depending on your job, you may find it difficult or impossible to work. You may also find that you cannot enjoy your hobbies, such as playing a musical instrument, due to this pain and lack of function. This can have a negative impact on your mental and emotional wellbeing, causing you to feel anxious and depressed.

Therefore it is important for your physical and mental health that you seek carpal tunnel treatment.

If your carpal tunnel syndrome is caused by pregnancy, then this usually resolves itself once the pregnancy is over.

Carpal tunnel surgery has a high success rate, with nine out of ten people noticing an immediate relief of their symptoms. Surgery is far more successful at relieving symptoms of carpal tunnel syndrome than non-surgical methods such as using a wrist splint or methods where there is limited evidence of them working, such as wrist exercises. Carpal tunnel surgery is the only really effective treatment for severe cases of carpal tunnel syndrome.

Carpal tunnel release is a quick and painless procedure with very little downtime. You will be able to use your hand for light tasks within just a couple of days of the surgery.

Here at the Cadogan Clinic you will find world-class surgeons who are experts in their field, which makes our clinic one of the leading destinations for carpal tunnel surgery in the UK. Book an appointment to find out how we can help you.


What are the risks?

Complications are rare although, as with all surgery, possible. Your surgeon will discuss each of these risks comprehensively at your consultation. 


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