Hand and wrist surgery · UK
Carpal tunnel release, by a specialist hand surgeon.
A day-case decompression of the median nerve - done by a BSSH hand and wrist surgeon with a high carpal tunnel volume, using open, endoscopic or WALANT technique matched to your job and severity. Home the same day.
Why patients choose us
- 01
A specialist hand surgeon, in a BSSH-linked unit
Not a general orthopaedic list. A named hand and wrist surgeon with a high carpal tunnel volume, working in a unit that meets British Society for Surgery of the Hand standards.
- 02
The right technique for your hand
Open, endoscopic or WALANT. We match the technique to your job, your severity on nerve conduction, and how quickly you need to be back at work.
- 03
Independent, and free
We are paid by no clinic, so the recommendation is impartial and costs you nothing.
Indicative pricing
What a private carpal tunnel release costs in the UK.
Indicative ranges across our partner units. Send the NCS report or your symptom description and we quote firm figures across two or three options.
In short
A unilateral WALANT release in our network: £2,400–£4,800, home within the hour.
| Procedure | Indicative range | Typical duration | Turnaround |
|---|---|---|---|
| Hand surgeon consultation and Tinel, Phalen and compression testing | £220–£350 | 30–45 min | Same visit |
| Nerve conduction studies and EMG (both hands) | £450–£750 | 45–60 min | 48 hours |
| Ultrasound-guided steroid injection into carpal tunnel | £380–£650 | 20–30 min | Same visit |
| Open carpal tunnel release (unilateral, WALANT or LA) | £2,400–£4,500 | 15–20 min | Same visit |
| Endoscopic carpal tunnel release (unilateral) | £3,500–£5,500 | 15–20 min | Same visit |
| Bilateral carpal tunnel release (open or endoscopic, one sitting) | £4,500–£7,500 | 30–40 min | Same visit |
Prices vary by unit, by which surgeon does the case, by anaesthesia (WALANT, LA or GA), and by whether one or both hands are done in one sitting. We come back with a firm quote within one working day.
The problem
The right diagnosis, the right technique, the right hand surgeon.
Carpal tunnel syndrome is a compression of the median nerve under the transverse carpal ligament at the wrist. Numbness in the thumb, index, middle and radial ring finger, worse at night, is the classic story. Late presentations lose thenar muscle bulk and never fully recover it.
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Is it really carpal tunnel?
Numbness that spreads into the little finger or up the forearm can be cubital tunnel, cervical radiculopathy or brachial plexopathy. Nerve conduction studies confirm.
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Have you tried the conservative steps?
A neutral wrist night splint and an ultrasound-guided steroid injection give 70 per cent short-term relief. Worth a proper trial before surgery.
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Want it done in a specialist hand unit?
A named BSSH hand surgeon, a CQC-registered day unit, and hand therapy in the same building - so scar and pillar pain get properly addressed.
The journey
From referral to hand therapy - what happens, in order.
One team from first message to review, including your hand therapy sessions and any late scar or pillar pain follow-up.
Phase 1 · Before your procedure
Concierge, off-stage for you
Phase 2 · On the day
A short visit at the unit
Phase 3 · After
Concierge, back on
- 01
Before
You send us the referral or NCS report
A short, confidential form. Where the symptoms are, how long you have had them, and any nerve conduction results, splint trial or steroid injection you have already had.
- 02
Before
We come back with a recommendation
Within one working day: whether open, endoscopic or WALANT release fits, or whether more conservative treatment is worth another look. Indicative price. An honest read either way.
- 03
Before
We arrange the procedure
Usually within one to two weeks. Anticoagulants and antiplatelets are reviewed with the team, and hand hygiene, nail polish and dressing instructions are sent.
- 04
On the day
Arrival at the unit
Arrival, consent and a chat with the hand surgeon. WALANT lignocaine and adrenaline into the palm, or a brief general anaesthetic if you prefer.
- 05
On the day
The release itself
15 to 20 minutes. Transverse carpal ligament divided under direct vision (open), through 1 to 2 endoscope portals, or through a 1.5 cm mini-open incision.
- 06
On the day
Home the same day
A thin dressing, written aftercare, and home within an hour or two. WALANT patients walk out with a light bandage and no sling.
- 07
After
Suture removal and hand therapy
Sutures out at 10 to 14 days for open release. Hand therapy exercises from day one. Review at 6 weeks and again at 3 months if pillar pain lingers.
Typical end-to-end: 1–2 weeks to procedure. Suture removal: 10–14 days. Review: 6 weeks.
When it helps
When release is the right step - and when it is not.
The presentations we see most, plus the clinical and electrophysiology findings that mean surgery is delayed, redirected, or not offered at all.
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Moderate to severe CTS on nerve conduction
Prolonged distal motor latency, reduced sensory amplitudes or denervation on EMG despite splinting and activity change.
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Nocturnal numbness and tingling
Waking most nights with pins and needles in the thumb, index, middle and radial half of the ring finger, relieved by shaking the hand.
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Thenar wasting or weakness
A flattened thenar eminence, weak thumb opposition or dropping cups and keys signals motor involvement. Surgery is time-critical.
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Failed splinting or steroid injection
A neutral wrist night splint or a 40 mg methylprednisolone injection helped briefly, then symptoms returned within weeks or months.
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Occupational impact
Numbness that interferes with driving, sewing, keyboard work or using tools. If the hand keeps letting you down at work, release is usually justified.
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Pregnancy-related CTS that has not settled
Most gestational CTS resolves after delivery. If symptoms persist beyond 6 months postpartum, release is offered on the same criteria.
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Pillar-only pain, no nerve signs
Aching over the base of the palm with no numbness, normal Tinel and Phalen and normal NCS. Release is not indicated. Look for tendinopathy or arthritis.
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Red flag: neck pain and arm-wide numbness
Numbness that spreads above the wrist, involves the little finger, or comes with neck pain suggests cervical radiculopathy or brachial plexopathy, not CTS.
Procedure options
Release is a family of techniques - matched to your hand.
What each option on the table actually involves - and which fits which patient. Try conservative measures first if severity is mild on NCS and there is no thenar wasting.
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Open carpal tunnel release (OCTR)
A 3 cm palmar incision. The transverse carpal ligament is divided under direct vision. Gold standard, cheapest, low complication rate. The workhorse in the UK.
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Endoscopic release (ECTR)
One or two small portals with an endoscope and hook knife. Return to work is typically 2 to 3 weeks faster, at higher upfront cost and a slightly higher transient nerve issue rate.
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Mini-open release
A 1.5 cm palmar incision with specialised instruments. A compromise between open and endoscopic: smaller scar than OCTR, no scope, lower kit cost than ECTR.
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WALANT (wide-awake, no tourniquet)
Lignocaine with adrenaline is injected into the palm. You stay awake, chatting, with no arm tourniquet, no sling and no bandage change. Walk out and use the hand the same day.
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Local anaesthetic day case
Standard local anaesthetic infiltration with a light arm tourniquet. Outpatient. No sedation needed for most patients. A short recovery and home within the hour.
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Bilateral in one sitting
Both hands released at the same visit for patients who cannot afford two recoveries. Usually WALANT, staged short breaks between sides. Increases early dependence on family.
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Revision carpal tunnel release
For incomplete release, symptomatic scar or recurrent CTS. Usually open with a longer incision, extended release and sometimes hypothenar fat pad interposition.
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Second-opinion review
A specialist review of your NCS report, symptoms and prior injection response. Sometimes the answer is another splint trial or a cervical spine MRI, not another operation.
Our vetted UK network
A small panel of BSSH hand surgeons, we picked them.
Fortius Clinic Hand and Wrist, London Hand and Wrist Unit, HCA The Wellington Hand Unit, Cromwell BUPA, London Bridge Hospital Hand Unit and Chelsea and Westminster Private Hand. Introductions are made privately, once we understand your case.
Selection criteria
How we choose every hand surgeon in our network.
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BSSH-affiliated hand and wrist surgeons with high carpal tunnel volumes
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CQC-registered units meeting BOA and BSSH standards for hand day-case surgery
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Hand therapy and revision pathways available when a first release has not settled
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WALANT and anaesthetist-delivered lists in the same building for patient preference
Safety and recovery
What to expect afterwards - honestly.
Carpal tunnel release is one of the safest hand operations. The things worth planning are your anaesthesia, pillar pain during the first six months, and hand therapy from day one.
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WALANT versus general anaesthetic
WALANT uses lignocaine with adrenaline in the palm. You stay awake and pain-free, without a tourniquet. A brief GA is available for patients who prefer to be asleep.
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Pillar pain for 3 to 6 months
Tenderness at the base of the palm on either side of the scar. Common, not a complication, and usually settles by 6 months. Hand therapy speeds it up.
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Incomplete release, roughly 3 per cent
A retained band of transverse carpal ligament leaves symptoms unchanged. Recognised at 3 months and treated with revision release.
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Nerve injury under 1 per cent
Injury to the recurrent motor branch or a palmar cutaneous branch is rare in experienced hands, and part of why endoscopic release carries a small transient risk.
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Recurrence around 5 per cent
True recurrence years later, usually after a good initial result. Confirmed on repeat NCS and treated with revision.
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Wound problems, 2 per cent
Delayed healing, mild infection or a hypertrophic scar. Kept low by careful skin technique, dressing changes and hand elevation for the first 48 hours.
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CRPS is rare but real
Complex regional pain syndrome after hand surgery is uncommon. Early mobilisation, hand therapy and good pain control reduce the risk.
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Realistic outcomes
85 to 95 per cent of patients lose night pain immediately. Sensation improves over 3 to 6 months. Motor recovery is slow and often incomplete if thenar wasting has been present for over 6 months.
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Red flags after discharge
Spreading redness, fever, worsening pain out of proportion, or new numbness of the little finger. Call the unit or go to A and E the same day.
Reading your operation note
Your operation note in four parts. Read the last one first.
Whichever technique was used, the note the hand surgeon sends you keeps to the same shape.
A quiet reminder
Operation notes are precise and can read coldly - we translate them for you.
If you would like us to talk you through the note before your review, just ask.
- 01 Header
Side, technique and anaesthesia
Which hand, which technique (open, mini-open or endoscopic), and which anaesthesia (WALANT, LA with tourniquet, or GA).
- 02 Technique
Ligament division and nerve inspection
Whether the transverse carpal ligament was fully divided under direct vision, and whether the median nerve looked flattened, hourglassed or normal.
- 03 Findings
Complications and intra-operative issues
Any tenosynovium excised, any bleeding, and the surgeon judgement on completeness of release.
- 04 Impression
Hand therapy plan and review interval
Read this first: dressing changes, suture removal date, hand therapy exercises from day one, and when you are next seen.
Recognised by major UK insurers
Cover for carpal tunnel release varies by insurer and by severity - usually funded once NCS confirms moderate or severe CTS. We confirm cover before booking.
Frequently asked
Everything we get asked about carpal tunnel release.
Quick answers on WALANT, open versus endoscopic, recovery, pillar pain and how quickly night symptoms settle.
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How long does carpal tunnel release take, and will I be awake?
The operation itself takes 15 to 20 minutes. Most UK patients now have it under WALANT, which means lignocaine with adrenaline injected into the palm. You stay awake, comfortable and chatting throughout, with no arm tourniquet. If you prefer to be asleep, a brief general anaesthetic is available. It is always a day case.
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Open or endoscopic - which should I choose?
Long-term outcomes are similar. Open release is the gold standard, cheapest and has the lowest complication rate. Endoscopic release usually returns you to desk work 2 to 3 weeks sooner and leaves a smaller scar, at a higher upfront cost and a slightly higher rate of transient nerve issues. If you do heavy manual work or your hand is essential to your income, we will help you weigh both.
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How much does private carpal tunnel release cost in the UK?
Roughly £2,400 to £4,500 for an open release on one hand, £3,500 to £5,500 for endoscopic release, and £4,500 to £7,500 for both hands in one sitting. A WALANT premium is £2,800 to £4,800. Nerve conduction studies and a hand surgeon consultation add £670 to £1,100. We confirm a firm figure within one working day.
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How soon can I go back to work?
Desk work: 1 to 2 weeks after open release, 3 to 7 days after endoscopic. Driving: once you can grip the wheel firmly, usually 1 to 2 weeks. Heavy manual work, tools or repeated gripping: 4 to 6 weeks. WALANT patients can use the hand for light tasks the same day, but heavy loading still waits for the ligament scar to mature.
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Will the numbness and weakness go away?
85 to 95 per cent of patients lose night pain the first night after surgery. Daytime numbness usually improves over 3 to 6 months as the median nerve recovers. Thenar muscle weakness recovers slowly and often incompletely if the wasting has been present for more than 6 months, which is why we do not delay surgery once motor signs appear.
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What is pillar pain, and is it normal?
Pillar pain is tenderness at the base of the palm, on either side of the scar, when you press or bear weight through the hand. It is common after any carpal tunnel release, is not a complication, and usually settles between 3 and 6 months. Hand therapy scar massage and desensitisation speed it up.
Ready when you are
Send us the NCS report - we come back within a working day.
A named BSSH hand surgeon, WALANT or endoscopic technique, and a firm price across two or three options. No obligation.
Related tests and treatments
Looking for something else?
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Nerve conduction studies and EMG
Confirms severity of CTS and excludes cervical or plexus causes.
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Carpal tunnel syndrome
The condition itself: causes, testing and non-surgical treatments.
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Cubital tunnel syndrome
Ulnar nerve compression at the elbow - the other common upper-limb nerve entrapment.
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Xiapex and needle fasciotomy for Dupuytren's
Non-surgical and minimally invasive treatments for Dupuytren contracture.
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Frozen shoulder treatment
Hydrodilatation, arthroscopic capsular release and physiotherapy for adhesive capsulitis.
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De Quervain tenosynovitis
Radial-sided wrist pain: splinting, injection and release surgery.
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