Carpal tunnel release: recovery and getting the hand back to normal

The carpal tunnel is a narrow passage at the wrist through which the median nerve and tendons pass. NHS inform describes decompression as reducing pressure on the nerve by opening the roof of the tunnel. The NHS describes the same operation as cutting the carpal tunnel so it no longer puts pressure on the nerve.

It is normally considered only after other treatments, such as night splints, have been tried and the condition is not settling or is getting worse. The surgeon will explain the options, including how the cut is made, and the risks that apply to your hand.

The NHS describes an injection that numbs the wrist so you feel no pain, a small cut in the hand, and an operation lasting about 20 minutes with no need to stay in hospital overnight. Because of this, most of the early recovery happens at home.

The pages used here do not describe bandage care, stitch removal or restrictions, and practices vary between hospitals. Ask the surgical team for written aftercare instructions covering how long to keep the dressing dry, when stitches are removed if they are not dissolvable, and what you may do with the hand straight away.

• Ask who to contact if the wound becomes red, hot, swollen or starts to leak.

• Ask which finger and hand movements to start straight away.

• Ask when you may drive and when you may lift, as official pages here set no fixed dates.

The NHS says it can take a month after the operation to get back to normal activities. That is a general guide, and people with heavy manual jobs or a long history of nerve compression may take longer to feel that the hand is fully back.

Gradual use is the usual pattern: light everyday tasks first, then increasing grip and weight as the scar and wrist become less tender. Scar tenderness at the base of the palm is common after the operation and often takes a while to settle, but the pages used here do not put a figure on it.

Surgery relieves pressure, but a nerve that has been compressed for a long time may take time to recover. Night-time tingling and pain often improve first, and numbness and weakness can be slower or incomplete if the nerve was damaged before the operation. The NHS pages do not quantify this, so ask your surgeon what to expect for your own hand.

The NHS says surgery usually cures the syndrome. If symptoms persist or return, they should be reviewed rather than assumed to be normal, since other problems, such as neck-related nerve compression or other nerve conditions, can have similar features.

NHS inform says that continuing to go to work or returning as soon as you can will help recovery, and that you do not need to be symptom-free before returning. For the first weeks after surgery that usually means adjusting tasks rather than staying away completely.

The pages used here do not set a date for driving or lifting. The NHS says in its page on broken wrists, for a different condition, not to drive until it is safe, and the same sensible rule applies here: wait until you can grip the wheel and control the car safely, and check any instructions from your hospital and insurer.

Contact the unit that did the operation, or use NHS 111, for signs of wound infection such as increasing redness, heat, swelling, discharge or fever, for severe pain not controlled by usual pain relief, or for new numbness or loss of finger movement after surgery.

If progress seems stalled beyond the expected month, ask for a review. Hand therapy, from a physiotherapist or occupational therapist, can help with scar tenderness, stiffness and grip, and the NHS says a physiotherapist can help with stiffness and weakness after a cast in a related setting.