Surgery for carpal tunnel syndrome

So we're talking about your carpal tunnel operation today. You probably already have symptoms of pain, tingling and numbness in your hand. The idea of doing it is to relieve the pressure on the nerve in the hand and hopefully get rid of some of those symptoms for you. Before I start, there's some caveats that I need to tell you about. What we do in a carpal tunnel operation is release the roof of the tunnel where the nerve is travelling into the hand and that is the nerve that's being pinched and causing all these symptoms. This procedure isn't perfect, by that I mean we can generally get rid of the pain for you but any established permanent numbness or some of the weakness in your hand may never go even though we've done this operation for you. But we definitely try to get rid of the pain. The procedure itself is very straightforward, usually do it in about 20 to 30 minutes under a local anaesthetic. By that I mean you'll have injection of numbing stuff around the hand but you yourself will be completely awake, therefore that means a very quick recovery. What we will get you to do is when you get into the operating room, have your arm straight out onto a board with a strap, so like a blood pressure cuff around the top and that controls any bleeding. To be honest that's probably the most uncomfortable bit because you'll constantly feel like you're having your blood pressure taken for about 20 minutes but it shouldn't be more than that so it's not long to bear. When we do the actual procedure we make a cut down the middle of the hand about an inch and a half and what we do is we go down and take off the roof of the tunnel where there's compression where there's pinching of the nerve. So we go down, we undo the roof, give it a wash and stitch the skin back up together again. So the procedure itself only takes about 20 minutes. At the end of the procedure, the stitches are ones that do need to be taken out by your GP's practice nurse in about two weeks. I'm afraid these are not the ones that are dissolvable. Over the top of that, you'll have a very small elastoplast dressing and then the big bulky wool and crepe bandage which you can cut off yourself with a pair of clean scissors in about three days' time at home. Things you need to know before you sign the consent form are the risks of the procedure. This is a very well tolerated, very successful operation, however it isn't completely 100% guaranteed to work. Other things that you need to note are that occasionally, very rarely, I've never seen it happen but it can happen, is that when we do the procedure we actually injure the nerve that we're trying to free. If that happens then we'll have to speak to you about it properly afterwards and depending on what we find we may need to send you to a small specialist hospital to deal with it. But like I said, that is a very rare complication, I've never personally seen it happen. Occasionally, the pain will completely disappear and you'll have a very good result for a few months, but it could come back because of scar tissue formation. Again, that's very rare, but it can happen. Other things that people notice are something called pillar pain, which is when because we've cut into your palm and you get lots of sensitive skin afterwards, in future when you try and push down on your hand and get up off a chair and use this bit of your palm and cause some irritation. That often goes, but you may need to massage it for the first three months. In general, these cases, people definitely go home the same day, but we ask you not to drive until the bandages come off, so the first three or four days. Going back to work, it does depend on what your profession is, but you have a normal desk-based job, recovery is usually about 24 hours. If you have a very heavy manual labour work that involves using your hands, you'd have to check that with your boss or at least wear gloves to protect the wound. We ask you not to get your hands really soaking wet, so not getting into a bath or swimming pool for the first two weeks, just until the stitches come out.