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Medically Reviewed April 2023, by Mr. Bryan Mayou (GMC: 1414396) - founder of the Cadogan Clinic and one of the world's leading plastic surgeons
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.
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.
Words from our clients:
"I was extremely satisfied with the care and treatment I received at the Cadogan Clinic. My surgeon was friendly and informative and explained the procedure fully. My procedure went very well and with the excellent care of the nursing staff, I made a speedy and full recovery. Would recommend to anyone."Eva Berry
"At the beginning before the operation the nurse taking care of me made me feel so comfortable. The surgeon and anesthetist helped me feel so calm. Fantastic before and after treatment"Scarlett Elliott
"The girls on the reception at the clinic were very pleasant and professional. The nurse who took out my stitches after my surgery was just lovely and took me through step by step what she was doing and she also recommended a great cream to use to help with healing."Georgina Nolan
“I was treated with care and provided with thorough knowledge about the procedure I was undertaking. My surgeon was very methodical (a perfectionist) and I felt I received A class treatment."Courtney O'Sullivan
"Outstanding experience from the first appointment to being discharged. Very professional, friendly and a fantastic outcome."Gemma Stevenson
"Reception staff very welcoming and efficient. Both nurses who I dealt with were fantastic, and the whole team (anaesthetist, surgeon etc) were friendly but professional, and really put my mind at ease. That I was able to stay later than I perhaps needed after my surgery to fit in with my husbands schedule was greatly appreciated."Emma Davies
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:
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.
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.
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.
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.
Open 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.
Endoscopic carpal tunnel release (keyhole surgery)
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.
We have invited a selection of the country's very best consultants to join us at the Cadogan Clinic so that you can be sure that whatever the nature of your treatment, you will be seeing one of the top practitioners in the country.
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 journeyThe Patient Journey
What is the recovery time for carpal tunnel release?
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.
How can I relieve carpal tunnel pain?
If you are experiencing pain or discomfort due to carpal tunnel syndrome, there are a number of things you can do to relieve this.
Ultimately, the most effective way of ridding yourself of painful carpal tunnel syndrome is by surgery.
Can I get carpal tunnel release on the NHS?
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.
How painful is carpal tunnel surgery?
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.
What happens if carpal tunnel is left untreated?
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.
What are the benefits of surgical treatment for carpal tunnel?
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.
Founded in 2004 by world renowned plastic surgeon Mr Bryan Mayou, we now work with over 100 leading consultants and successfully treat over 20,000 patients each year. We have been winning industry awards since inception.About Us
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All of our treatments take place at our beautiful boutique premises in Chelsea. We have six consulting rooms and five operating rooms, as well as a dedicated pre and post-operative suite, and a full team of specialist nursing staff.Our Clinic
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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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