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Carpal tunnel surgery is an orthopaedic procedure which is undertaken to relieve carpal tunnel syndrome, a condition which affects the wrist and ultimately the hand and fingers. As with many orthopaedic conditions, patients are encouraged to try other non-invasive treatments before carpal tunnel syndrome surgery is performed.
Carpal tunnel syndrome occurs when the median nerve in the wrist becomes squeezed or compressed. The median nerve gives the thumb, index finger, middle finger and, to some extent, the ring finger the ability ‘to feel’. It is usually most pronounced in the area of the thumb, causing numbness, weakness and tingling. Surgery attempts to release or decompress the median nerve so it is sometimes known as carpal tunnel release surgery or carpal tunnel decompression surgery. Both these names refer to exactly the same procedure for the relief of carpal tunnel syndrome.
Carpal tunnel surgery relieves carpal tunnel syndrome
The carpal tunnel syndrome operation is usually performed on an outpatient basis. The carpal tunnel is enlarged, so that the median nerve has more space and is not compressed. Usually this carpal tunnel syndrome treatment will correct the situation, although full recovery can take up to a year. It is possible that the condition may sometimes recur, however this is rare. So, surgery is a carpal tunnel syndrome cure, although there may be other less invasive, but successful, solutions, particularly if the condition is spotted and treated early on. As with many other problems connected with body joints, when other treatments do not work, the last resort is surgery; carpal tunnel syndrome is no different.
A carpal tunnel is found in each wrist. It is on the ‘palm’ side of the wrist and is about one inch wide. The tunnel is formed by small bones called the carpal bones and is capped by a strong band of tissue which is the carpal ligament. Hence the space inside is totally surrounded and cannot expand or change shape.
The very important median nerve goes through this tunnel. This nerve starts in the neck, goes down the length of the arm, through the carpal tunnel and into the hand. It gives our fingers, particularly the thumb, index finger, middle finger and ring finger, the ability to ‘feel’ and also controls the muscles around the thumb. The flexor tendons, which are used to bend the fingers and thumb, also go through the carpal tunnel.
Carpal tunnel syndrome occurs when the tunnel starts to narrow, often because the tissues around flexor tendons become swollen. They then press on the median nerve. This pressure on the nerve leads to pain, numbness, tingling and weakness in the hand.
The treatment of carpal tunnel syndrome basically sets out to eliminate or, at least, decrease this pressure on the median nerve. When it comes to the matter of how to help carpal tunnel syndrome, if identified early, there are a few non-invasive methods available which will alleviate the pain. When the carpal tunnel pain becomes noticeable, it is highly unlikely that the condition will resolve itself without any action being taken.
Carpal tunnel syndrome occurs when the tunnel starts to narrow, often because the tissues around flexor tendons become swollen.
What are the symptoms of carpal tunnel syndrome and how do you know if you have it? Often the symptoms of carpal tunnel syndrome start slowly and the person may not even be aware that they have a problem. Initial signs may be that the fingers become numb at night, usually due to the angle that the hand is being held at while the person is sleeping. In the morning, upon awakening, this may lead to numbness and tingling in the hands which may even run up to the shoulders.
During the day, it may become uncomfortable, and eventually painful, to hold something with the wrist bent e.g. when driving or reading a book. At this stage ‘shaking out’ the hand may relieve the pain, however, as the condition worsens, this will work less and less.
With the progression of carpal tunnel syndrome, symptoms in the hand become even more pronounced. The muscles in the hand may shrink meaning the ability to grip will be compromised and there may be more pain and muscle cramping. The median nerve cannot work properly so there will be less feeling in the fingers and less strength and co-ordination.
In summary, carpal tunnel syndrome symptoms include:
What causes carpal tunnel syndrome? The most common carpal tunnel syndrome causes are an underlying medical condition or repeated motion of the wrist. The most frequent underlying conditions associated with this syndrome are: diabetes, rheumatoid arthritis, a thyroid imbalance and high blood pressure. Certain lifestyle factors such as smoking, high salt intake, sedentary lifestyle and a high BMI also increase the risk.
Carpal tunnel syndrome is a type of ‘Repetitive Strain Injury’ (RSI). RSIs are triggered by repeating the same physical action. In the case of carpal tunnel syndrome – causes may be actions such as:
In addition to all of this, there are also some groups of people who are at a greater risk of carpal tunnel syndrome:
The most common carpal tunnel syndrome causes are an underlying medical condition or repeated motion of the wrist.
Before even thinking about surgery, it is important to get a clear carpal tunnel syndrome diagnosis. Other conditions which may have similar symptoms include thoracic outlet syndrome , arthritis, RSI and wrist tendonitis. Only a doctor can 100% confirm that the condition is carpal tunnel syndrome.
During a carpal tunnel diagnosis the doctor will ask questions about the patient’s lifestyle and medical history, in addition to conducting a short physical examination of the hand, arm and shoulder. There is a large choice of other carpal tunnel syndrome tests which doctors can use in their diagnosis. Here are some of them:
X-rays, MRIs and Ultrasounds – these tests usually take place to rule out any other possible conditions.
Generally, a confirmed diagnosis will not need all these tests, only one or two will be carried out. However, only after this confirmed carpal tunnel syndrome diagnosis will a doctor even consider surgery and then the question to be answered is – should I get carpal tunnel surgery?
Before even thinking about surgery, it is important to get a clear carpal tunnel syndrome diagnosis.
Most doctors would recommend trying less invasive methods of treatment for 3-12 months from the first onset of symptoms before resorting to surgery. Any surgery carries a very minor risk, so if a condition can be treated in some other way this will always be a better and safer option. In fact, when carpal tunnel syndrome is caused by underlying conditions like rheumatoid arthritis, hypothyroidism or diabetes, the treatment of these conditions may drastically improve the symptoms of carpal tunnel syndrome and, in some cases, it may even disappear.
If the condition is diagnosed early, so the symptoms are not too severe, often simple lifestyle changes can correct the problem. These may include avoiding and/or improving the positions where the wrist is over extended, wearing a wrist splint at night, treating the immediate pain with over-the-counter painkillers and anti-inflammatories, exercises and, of course, treating any underlying conditions. For many people, these things will greatly improve or even correct the carpal tunnel syndrome.
So, in answer to the question – do you need surgery for carpal tunnel syndrome – the answer is often – no, not necessarily. Some research has been carried out between surgical and non-surgical treatments for carpal tunnel syndrome. One study showed that 32% of patients showed improvement after non-surgical intervention.
As with many conditions, if left untreated, carpal tunnel syndrome will get progressively worse. If the pins and needles in the hand are keeping the person awake at night or they are continually dropping things or unable to pick up small objects then the situation will probably not change without some kind of intervention. If it gets to the stage where the hand is completely numb this may mean that the median nerve has become so compressed that the muscle has atrophied and the nerve damage may well be permanent.
If carpal tunnel syndrome is not treated, the damage may become permanent.
It is essential, therefore, that the carpal tunnel syndrome is diagnosed as soon as possible, so that non-surgical treatments can be started. If these do not solve the problem after 3-12 months, then surgery may be necessary.
What will happen if carpal tunnel syndrome is not treated? – there is the possibility that the damage may become permanent. If the nerve damage is becoming permanent there will be numbness at the tips of the thumb, index and middle finger. The thumb may also change shape and the muscles that move the thumb will become extremely weak. Eventually the numbness may spread to all of the entire finger/thumb and then to the palm of the hand. This can be dangerous as the person may not notice if they scald themselves or injure their hand in other ways.
As can be seen it is important to have carpal tunnel surgery at the right time to prevent permanent damage to the nerve and muscles in the hand. It is essential, therefore, that the carpal tunnel syndrome is confirmed as soon as possible, so that the severity of the condition can be established. In most cases, the doctor will suggest non-surgical treatments as these can be very effective and pose no risk whatsoever to the patient. Depending on the severity of the carpal tunnel syndrome and its response to the non-invasive treatments, the doctor will decide how long to continue with these treatments.
However, if the carpal tunnel syndrome does not appear to be improving, then the doctor will decide when it is time to have carpal tunnel surgery. It is important that a medical professional decides for the patient when to have carpal tunnel surgery, because, as with many medical operations, the timing of the surgery is important for a successful outcome. Most patients will be able to establish when to get carpal tunnel surgery in consultation with their doctor.
Carpal tunnel syndrome during pregnancy is very common.
Carpal tunnel syndrome during pregnancy is very common. It is estimated that between 31%-62% of pregnant women may experience carpal tunnel syndrome. During pregnancy swelling often occurs due to changes in hormone levels. This swelling can affect the wrist and carpal tunnel, leading to compression of the median nerve.
It occurs most frequently in the third trimester, but it can occur at any time, even after the birth. When it comes to carpal tunnel syndrome, pregnancy means that in about 50% of cases, the condition occurs in both hands. In most cases the condition will disappear within 12 months after the birth.
Risk factors which increase the chances of carpal tunnel syndrome in pregnancy include:
Due to the fact that, with carpal tunnel syndrome and pregnancy, the condition usually rectifies itself after the birth, treatments tend to be non-invasive and conservative: wrist splints, exercise, yoga, cold therapy and painkillers.
Carpal tunnel syndrome is not life threatening, however it can make life very difficult for those who have it. Simple tasks like opening a jar, doing buttons up and picking small things up from the floor become extremely difficult and therefore it does have an impact on the person’s quality of life. The pain, numbness and weakness in the hands and wrists can leave people mentally, emotionally and physically exhausted.
Carpal tunnel surgery is usually seen as a last resort. Often non-invasive methods of treatment can rectify the situation. If carpal tunnel syndrome has been brought on by underlying health problems such as rheumatoid arthritis, hypothyroidism or diabetes, treatments for these conditions should take place first. Carpal tunnel surgery, in these cases, may only provide a small amount of relief.
If symptoms persist, however, and non-invasive treatments are not working, then surgery will be necessary. The effectiveness of the surgery is difficult to predict. It depends on how severe the symptoms are, how long the patient has had carpal tunnel syndrome and any underlying health problems. About 75%-90% of patients report that they are symptom-free after several years or there is an improvement in their symptoms.
So, is carpal tunnel syndrome surgery worth it? – when other non-invasive treatments have been tried without success and the symptoms are affecting the patient’s quality of life, then yes, carpal tunnel syndrome surgery is worth it.
‘Carpal tunnel release’ is the surgical procedure, which is carried out to relieve the symptoms of carpal tunnel syndrome. There are two different types of carpal tunnel surgery. However, the aim of both of these carpal tunnel surgery options is to enlarge the tunnel in order to release, or alleviate the pressure on, the median nerve. Before either procedure takes place the patient may be asked to not eat or drink anything for 6-12 hours beforehand.
The carpal tunnel syndrome surgery options are open carpal tunnel release and endoscopic carpal tunnel release. Both of these types of carpal tunnel surgery are usually performed on an outpatient basis. A general anaesthetic may be administered or, very often, just a local anaesthetic is used which numbs the hand and arm. As with many local anaesthetic procedures the patient is also often given a mild sedative intravenously. The whole procedure usually takes about 20-30 minutes, although patients will be expected to stay in the hospital a little longer just to check that everything is OK post-surgery and that the patient has recovered from the anaesthetic without any problems. Overnight stays are very rare.
If the carpal tunnel syndrome is extremely severe, surgery may not resolve the problem 100%, however it should bring some relief and will prevent further damage to the nerve.
Open carpal tunnel surgery is the traditional procedure for releasing the median nerve. It is also sometimes known as open release carpal tunnel surgery or even open carpal tunnel release surgery. All these procedures are the same. After the local, or sometimes general, anaesthetic has been administered, the doctor will make a small cut – about two inches (5cm) long in the palm of the hand. This will enable him/her to see the inside of the wrist and hand. In order to release the median nerve, the doctor will cut the ligament(s) in the roof of the carpal tunnel, this will immediately increase the size of the tunnel and the compression on the median nerve will be alleviated. Post surgery, the ligament(s) may grow back together again, but this time there will be more room for the median nerve.
Endoscopic carpal tunnel surgery is also sometimes known as carpal tunnel keyhole surgery. This is because it is performed by making one or, usually, two much smaller incisions and the doctor views the inside of the hand and wrist with the help of an endoscope. The incisions are about ½ “ (1.25cm) long, one on the wrist and the other in the palm of the hand. An endoscope, which is a narrow tube with a small camera on the end of it, is then inserted into the hand. This tiny camera is then used by the doctor to view the carpal tunnel and make the necessary cuts in the ligament(s). This is done by inserting a small cutting instrument through the second incision. Endoscopic carpal tunnel release surgery is technically more challenging for the surgeon and requires very specialised training. However, using the carpal tunnel surgery endoscopic method does usually mean a slightly quicker recovery time and possibly less scarring.
Different surgeons have differing opinions about the advantages and disadvantages when it comes to carpal tunnel endoscopic vs open surgery.
There can be no doubt that endoscopic surgery has a faster recovery time and the wounds and the swelling associated with them are much reduced and heal quicker. Some surgeons believe that endoscopic carpal tunnel surgery carries a greater risk of complications than the open carpal tunnel surgery. However, this risk is still extremely slight. As with any keyhole-type surgery the surgeon has a reduced view of the site of the operation and very occasionally this can cause problems.
A 2019 research paper – Endoscopic versus Open Carpal Tunnel Release – noted that ‘patients report greater satisfaction with endoscopic surgical approaches compared with open techniques’ and that there is ‘evidence to suggest that both approaches are comparably safe and equally effective’. Another study from 2007, where half the participants had open carpal tunnel surgery and half had endoscopic surgery, showed that in the ‘endoscopic group’ there was less local wound problems and a quicker return to normal activities. Furthermore, three months after the surgery, there was no significant difference in the overall success of the operations and nobody suffered any major complications.
Despite these and similar studies, many surgeons still practise open carpal tunnel surgery e.g.only 20% of surgeons in the USA use the endoscopic method. However, it should be remembered that when it comes to the endoscopic vs open carpal tunnel surgery debate, the experience and training of the surgeon performing the procedure is. perhaps, the most important factor.
The choice is to have the carpal tunnel surgery either simultaneously or consecutively.
The most obvious advantage of simultaneous surgery is that there is only one session of surgery and only one recovery period and, therefore, costs are much cheaper. However, considering that, after carpal tunnel surgery, both hands will be out of use for, maybe, up to 14 days, this option needs some very careful planning. This will mean relying totally on another person for many everything. In addition, when this person is not available for any reason there may be a huge temptation to attempt to do things with one or both hands and this could affect the successful outcome of the surgery.
The alternative is consecutive carpal tunnel syndrome surgery, where two operations are performed, with time after the first one for the hand to recover before the second hand is operated on. Obviously, this means having two sessions of surgery and going through two recovery periods. In addition, in some cases, additional activity and stress on the ‘good’ hand after the operation, could worsen the symptoms in this hand very quickly.
The question of whether to have simultaneous or consecutive carpal tunnel syndrome surgery must be a matter for discussion between the doctor and the patient. It will depend on things like whether the patient will have enough support when both hands are out of use and how bad the symptoms are in each hand.
Bilateral carpal tunnel syndrome surgery – carpal tunnel surgery, performed on both hands.
The carpal tunnel surgery procedure is the most frequently performed surgery by hand surgeons. In the UK, 855,832 carpal tunnel syndrome surgery procedures were carried out between April 1, 1998, and March 31, 2017, and in the USA, there are well over 230,000 procedures performed annually – the second most common type of surgery. The carpal tunnel syndrome surgery procedure is nearly always performed on an out-patients basis, often taking just 10-20 minutes plus recovery time from the anaesthetic. The success rate is over 90% and brings relief for the patient almost immediately.
What type of doctor treats carpal tunnel syndrome? There are actually a few different hospital departments that may be involved in the treatment of carpal tunnel syndrome.
Let’s first consider what kind of doctor diagnoses carpal tunnel syndrome. This condition falls under the general category of orthopaedics. The doctor involved in the diagnosis of this syndrome is usually an orthopaedic hand specialist. However, another type of doctor for carpal tunnel surgery may be involved – a neurologist. This is because this condition is a peripheral nerve disorder where a nerve is becoming pinched or compressed. Peripheral nerves link up with the central nervous system i.e. the brain and spinal cord.
In fact, various specialists may be involved in the treatment package for carpal tunnel syndrome including orthopaedists, neurologists, physiatrists (specialising in physical medicine and rehabilitation) and, even, plastic surgeons. However, in the majority of cases such a large group of specialists will not be required. When considering what type of doctor performs carpal tunnel surgery, it is usually an orthopaedic hand specialist. This is usually the best doctor for carpal tunnel surgery.
Orthopaedic hand surgeons specialise in the diagnosis and treatment of disorders of the fingers, hands, wrists and forearms. In line with many other countries a carpal tunnel syndrome doctor UK-based must firstly train as a medical doctor. They then spend up to six years specialising in orthopaedics or, sometimes, plastic surgery. After this they undertake further additional training which focuses on the hand, wrist and forearm.
Carpal tunnel surgery is very common surgical procedure.
Once the surgery is confirmed to take place on a certain date, the only question then is how to prepare for carpal tunnel surgery. The preparations are really the same as for many other surgical procedures.
How long is carpal tunnel surgery? Carpal tunnel surgery is usually performed quite quickly. Generally speaking the procedure will take about 20-30 minutes after the anaesthetic has taken effect. However, expect to be in the out patients’ unit a little longer as checks will be made after the surgery to ensure that everything is OK after the anaesthetic. So, after taking everything into consideration, the answer to the question -‘carpal tunnel surgery: how long does it take?’ is somewhere between one and two hours in normal circumstances.
Anaesthesia is a medication which controls pain during surgery and may also help with controlling breathing, blood pressure and heart rate. There are different types of anaesthesia – local, regional or general. Most often a local anaesthetic is used for carpal tunnel surgery, however factors such as length and complexity of the surgery, the patient’s general medical condition and preferences of the surgeon and patient all have to be taken into account before a final decision on the anaesthesia used for carpal tunnel surgery can be decided.
General anaesthesia for carpal tunnel surgery is usually administered by way of a mask which delivers a type of gas to put the patient to sleep. Sometimes it can be administered via an intravenous line. The patient is unconscious and will feel nothing during the procedure. Airway and breathing support from a ventilator is needed.
Local anaesthesia for carpal tunnel surgery, essentially means injecting a numbing medicine at the site of the surgery. They may last for between one and eight hours. With only a local anaesthetic the patient will be wide awake.
Monitored anaesthesia care (sedation) is sometimes given in tandem with the local anaesthesia for carpal tunnel surgery. This medication, administered through an intravenous line, helps the patient to relax. These types of medicines often make the patient lose their short-term memory, so, although awake throughout, they may actually forget being in surgery.
Regional carpal tunnel surgery anaesthesia is very similar to a local anaesthesia except that it is injected into the nerve paths. As with local anaesthesia for carpal tunnel surgery, sedation is often also administered .
How painful is carpal tunnel surgery? The actual surgery procedure itself should not hurt, thanks to the anaesthetic, either local or general. As with any operation there will be some pain and discomfort later from the incision as it heals. However, this can usually be controlled with over the counter painkillers. Continued pain from the incision area (two weeks or more after surgery) may mean an infection, so should be checked out. In some cases, numbness or tingling may last for months.
After surgery the carpal tunnel will have been enlarged and this should bring immediate relief. The recovery period after carpal tunnel surgery is generally quite short, although the hand will be out of use for up to 2 weeks. Endoscopic carpal tunnel surgery recovery time may be a few days shorter. Although relief from the symptoms is usually immediate there will be some after effects of the surgery, so, in reality, the carpal tunnel syndrome surgery recovery time, to the point where the strength in the hand has been fully restored, can be up to 12 weeks.
Generally, there are no carpal tunnel surgery recovery symptoms, any pain will be mild and can be easily controlled by over-the-counter painkillers. Let’s look at what to expect after carpal tunnel surgery relief and recovery.
How long does it take to recover from carpal tunnel surgery? As mentioned earlier, the actual procedure is performed on an out-patients basis and takes 20-30 minutes and, in the hospital setting, the recovery time after carpal tunnel surgery is very short and purely dependent on how well the patient reacts to the local anaesthetic. Even where a full anaesthetic has had to be given it is extremely unusual for any overnight hospital stay to be necessary. Where possible, the incision will be made in a natural crease in the hand so that when it heals the scar will not be too visible. The hand will be bandaged to support the wrist although the fingers should be free. All in all, patients should be able to return home after a few hours. Thus, the hospital recovery time for carpal tunnel surgery is very short.
The carpal tunnel surgery recovery timeline may last up to three months. Initial recovery, however, is quite fast, however the body’s healing process after carpal tunnel surgery, or indeed any surgery, may take a little longer.
Below is a timeline with the usual stages of recovery from carpal tunnel surgery. Please remember that everyone’s body is different so recovering from carpal tunnel surgery will vary from person to person.
Period After Surgery
Expected Progress
Immediately after surgery
The wound will be dressed with a bandage to support and protect it, but the fingers will be free to move. The dressing should not get wet so put a plastic bag over the hand when showering. Moving the fingers from time to time will minimise swelling. The hand should be elevated above heart level, so a sling may be provided for the arm. Night pains (tingling and numbness) should be immediately relieved.
A few days after surgery
Some people will be able to drive now, but generally it is best to wait 1-2 weeks. A 1lb (approx 0.5kg) weight limit on the hand.
1-2 weeks after surgery
The dressing will be removed. During this time some patients will be given hand exercises to do in order to prevent stiffness in the fingers. The hand may be used for light tasks which do not strain or pull the hand. Patients may return to work provided the work does not include repetitive movement of the hand e.g. typing or assembly-line work. A 3lbs (approx 1.4kg) weight limit on the hand. No power gripping or vibrating tools.
2-4 weeks
After the dressing is removed, some patients may be given exercises. These exercises will improve hand and finger movement and may also speed up the recovery process. Writing is possible but it may be difficult. 5lbs (approx 2.2kg) weight restriction - no power or vibrating tools.
4-6 weeks
Writing will become much easier. 15lbs (approx 7kg) weight restriction - no power or vibrating tools.
6-8 weeks
Light pulling, gripping and pinching will be possible, although the hand will still be weak. There may still be some soreness in the palm when it is touched or deep pressure is applied.
10-12 weeks
The strength in the hand will return, however in severe cases it may take up to 12 months.
12 months
Most patients will now be feeling all the benefits of their carpal tunnel surgery. Those patients who had severe or chronic median nerve damage, pinched nerves in the neck, or wasting of muscles before the surgery may still have limited hand function and strength.
Carpal tunnel release surgery is a low-risk procedure which is successful in rapidly relieving nighttime and neurological symptoms. The numbness, coordination, and strength in the hand will gradually improve over several weeks and months and may continue to improve up to or beyond a year from the carpal tunnel syndrome operation.
Immediately after the carpal tunnel release surgery the hand will be bandaged to help stabilise the wrist. In some cases a splint may be used. A frequently asked question is – when can I take bandage off after carpal tunnel surgery? The bandage after carpal tunnel surgery will normally remain on the hand for 5-14 days. Some surgeons are happy for the patient to remove the dressing after a certain number of days, other surgeons would prefer to remove the dressing themselves. It is better to check what the surgeon expects. Using a sling will also help to keep the hand above heart level thereby combating swelling and inflammation. The carpal tunnel bandage should be kept clean and dry. When taking a shower/bath, place a plastic bag over the hand to prevent it getting wet.
Although research shows mixed results, generally non-absorbable stitches are preferred for carpal tunnel surgery stitches. How many stitches for carpal tunnel surgery? This will vary depending on the length of the incision. How long do stitches stay in after carpal tunnel surgery? The answer is somewhere between 7-14 days but again the surgeon is the best person to advise on when the stitches after carpal tunnel surgery can be removed. Removing stitches after carpal tunnel surgery can usually be done by the local GP practice nurse. This may need to be booked fairly quickly after the surgery.
As is common with any surgical procedure, bruising after carpal tunnel surgery is normal. Usually it appears on the palm and the wrist. This carpal tunnel surgery bruising can be alleviated by soaking the hand in warm water. Fill a sink or washbasin with warm water and then soak the hand in it for 5-10 minutes. This will help with the bruising as well as reducing any stiffness in the hand and fingers. The bruising after carpal tunnel surgery is generally confined to the hand and wrist, where there is bruising on forearm after carpal tunnel surgery this should be investigated further.
How long are you out of work for carpal tunnel syndrome? There is no definitive answer to this. There are a lot of factors which come into play when considering time off work after carpal tunnel surgery. These include such things as the original severity of the condition, the patient’s individual recovery time as well as the type of work.
If your work does not include repetitive movement of the hand or the necessity to carry quite heavy objects, you may back to it after 2 weeks after surgery.
Where recovery from carpal tunnel surgery is within the usual timeline, some patients may return to work about two weeks after surgery providing their work does not include repetitive movement of the hand or the necessity to carry quite heavy objects. Other factors to take into account is whether the job includes a lot of driving and the ability to use public transport where a car is not available. A 2019 survey (Return to work after carpal tunnel release surgery) showed that those patients who were self-employed or on nil hour contracts were the most likely to return to work earlier. Most respondents, however, took carpal tunnel surgery time off work as directed by their surgeon. The majority also confirmed that on their return to work they had to adapt initially to take into account the weakness in their hand.
Obviously, those people who use vibrating power tools on a regular basis or whose work involves repetitive movement like typing will need to take longer before returning to work. An agreement may need to be reached with the employer for a graded increase in hand function at work.
Guidelines state that driving after carpal tunnel surgery should be possible after a few days. However, this may not always be the case. When it comes to carpal tunnel surgery recovery time, driving may depend on the type of car and which hand has had the surgery.
For those people driving after carpal tunnel surgery, UK based, the car insurance company should be informed about the operation. Some companies will not insure drivers for a certain number of weeks after surgery so it’s very important to check the policy. Ultimately only the patient can know when they are able to drive safely. It is advisable to start with short journeys and the driver should be able to comfortably control the steering wheel and safely control the car including being able to perform an emergency stop.
Here are some carpal tunnel surgery recovery tips which may be of help:
Much of the carpal tunnel `surgery aftercare has been covered in the recovery section above. It is important to remember that as with any surgery, and especially after any orthopaedic surgery, the aftercare can be almost as important as the actual surgery when it comes to ensuring a successful outcome. Immediately after carpal tunnel surgery it is important to rest, this will help the body to heal itself. Some of the symptoms of carpal tunnel post surgery will disappear completely, but complete healing after carpal tunnel surgery will take some time.
Carpal tunnel surgery post op care should include plenty of rest so that the body can heal itself but also a gradual increase in exercise. Patients should try to walk each day, slowly increasing the amount bit by bit. Ice and elevation are the key words for preventing excessive swelling and inflammation.
Other important carpal tunnel surgery aftercare instructions include exercising the hand to prevent stiffness and, of course, taking care of the wound itself.
The Internet provides many good carpal tunnel surgery aftercare blogs, often written by people who have actually gone through the surgery themselves. They often provide very useful hints and tips.
As already mentioned, in order to prevent stiffness and swelling in the hand and speed the recovery process after carpal tunnel surgery, it is important to maintain movement in the hand. The best way of doing this is by doing some simple post carpal tunnel surgery exercises. Some of these exercises after carpal tunnel surgery focus on flexibility while some others focus on building up the strength in the wrist and hand. Some of the exercises can be performed just a few days after surgery. Generally, they will need to be performed everyday for about 4-6 weeks after the operation. If there is a marked increase in pain, stop doing the exercise immediately and consult the doctor or a physiotherapist.
a) Make a fist with the hand, with the thumb outside ‘the fist’. You should be looking at the ‘side’ of the fist b) Slowly straighten the fingers keeping the thumb close to the index finger c) Keeping the finger and thumbs in this position gently bend the hand back towards the forearm. d) Maintaining the same position of the wrist and fingers slowly extend the thumb outwards e) Keeping the wrist, fingers and thumb in position gently rotate the wrist and turn the hand until you are no longer looking at the side of the hand but at the palm which is still pointing upwards f) Use the other hand to extend the thumb further
a) Fully straighten the fingers and thumb on the hand. Bend the tips of the fingers so that they create ‘hooks’. Knuckles should be pointing upwards. Continue to lower the fingers so that they make a tight fist with the thumb on the outside. b) This second exercise is very similar, except that instead of forming ‘hooks’ with the fingers, bend the fingers at the bottom knuckle so that a ‘tabetop’ is formed. Then touch the fingers to the palm by bending them in the middle.
The focus for all the above carpal tunnel exercises after surgery – strengthening and flexibility, will ensure that normal function and ability returns to the hand as soon as possible.
In order to prevent stiffness and swelling in the hand and speed the recovery process after carpal tunnel surgery, it is important to maintain movement in the hand.
Generally, most patients will not require official hand therapy after carpal tunnel surgery. For this reason it is important that patients perform their exercises at home. Many hospitals will give patients leaflets or access to websites which include instructions for exercises and therapy post carpal tunnel surgery. In exceptional circumstances, medical staff may decide that it would be particularly beneficial for a patient to have physical therapy after carpal tunnel surgery. This will often be carried out by a professional occupational physiotherapist who will have regular sessions with the patient. However, it must be said that official physical therapy after carpal tunnel release surgery is the exception rather than the norm.
Any medical operation where an incision is made in the skin will be painful for a week or two afterwards and carpal tunnel surgery pain is no different. Considering how much pain after carpal tunnel surgery most people experience, it can be said that, in normal circumstances, the pain after carpal tunnel surgery should not be too intense and can be controlled by over the counter painkillers.
Where a local anaesthetic has been used, some patients experience a burning pain after carpal tunnel surgery. This is because the anaesthetic will have numbed the hand and wrist. As this feeling wears off, sometimes several hours later, and the nerves come back to life, it is not unusual to feel a tingling or burning sensation in the hand. If the numbness from the surgery lasts over 24 hours it should be checked out by a doctor.
Extended post carpal tunnel surgery pain may be due to damage to the median or nearby nerves and blood vessels and/or infection of the wound among other things. These are all carpal tunnel surgery risks which happen very rarely. Our section on problems after carpal tunnel surgery and side effects gives more information about these uncommon carpal tunnel surgery risks.
The pain after carpal tunnel surgery is more often felt in the hand itself. There are two different kinds of pain in hand after carpal tunnel surgery. The first type is known as ‘incision pain’ and this can be felt directly at the site of the incision. This type of pain is normally only present for days or weeks after the surgery. This pain can be alleviated by protecting the incision and avoiding lifting or gripping for several weeks after the surgery.
The second type of hand pain after carpal tunnel surgery is known as ‘pillar pain’. This pain is slightly different to the incision pain as it is sited slightly away from the incision in the thicker parts of the palm known as the thenar and the hypothenar eminence. These are the locations where the transverse ligament is attached to the carpal bones as well as some of the hand muscles. Pillar pain is a common complication of carpal tunnel surgery. It can be quite troublesome and may last for several months. It is usually treated with rest, massage and therapy.
Occasionally, after carpal tunnel surgery, numbness, fingers mainly, may continue to be experienced. This may be due to the transverse carpal ligament not being completely released (more common with endoscopic surgery) or that, despite the surgery, the median is so badly damaged that it may never return to normal.
Other sites for possible pain after carpal tunnel surgery include the wrist and arm. Although wrist pain after carpal tunnel surgery may even be worse initially, this should resolve itself fairly quickly. Wearing a wrist brace may help to stabilise the wrist joint. If a patient is suffering with a long-term ‘pain in wrist’ after carpal tunnel surgery, this should be investigated further using the available tests. Some patients also complain of ongoing ‘pain in arm’ after carpal tunnel surgery. If this pain continues it should be checked out by a doctor as it may mean that the median nerve is pinched further up the arm rather than at the wrist.
Pillar pain and incision pain are two types of pain after carpal tunnel surgery.
Thumb pain after carpal tunnel surgery is usually connected with ‘pillar pain’. This ‘pain in thumb’ probably emanates from the base of the thumb where the thenar eminence muscles are located. This is considered to be normal for between two and six weeks after surgery, but may sometimes last for up to 3 months. In exceptional cases, thumb problems after carpal tunnel surgery may persist for up to a year after surgery, but this is very rare. Exercising the hand and thumb will help. The reason for pillar pain is still largely unknown.
Swelling after carpal tunnel surgery is normal. How long does swelling last after carpal tunnel surgery? It will last for probably about one to two weeks after surgery, but in some patients it may last even longer. It manifests itself not only in hand swelling after carpal tunnel surgery, but also in swollen fingers after carpal tunnel surgery. This swelling may be painful and often leads to stiffness, especially in the fingers. Taking steps to reduce the swelling will ensure a quicker recovery and relieve the pain. Initial swelling pain after carpal tunnel surgery is normal, however if it shows no signs of beginning to subside after a few weeks it is best to consult a doctor.
The following steps will help to reduce the swelling and relieve the pain associated with it. They will also quicken the recovery process.
Is it normal to have numbness after carpal tunnel surgery? Yes – numbness after carpal tunnel surgery is normal. The numbness experienced immediately post-surgery is due to the local anaesthetic which is usually used in carpal tunnel surgery. This initial numbness and possible subsequent tingling should disappear in a few days at the most.
However, prolonged hand and finger numbness after carpal tunnel surgery may be due to a few different reasons. Firstly, the median nerve may already have been badly damaged or may have been damaged during the surgery and will take some time to repair itself (although there is a chance that it may never repair itself totally). Generally, a bruised or traumatised nerve will recover in 6-12 weeks. If it has been cut, it will ‘rest’ for about a month and then start to regrow at the rate of 1mm per day. So, there may be a continual improvement of the numbness over many months.
Occasionally, numbness in fingers after carpal tunnel surgery is caused because, for some reason, the surgery had failed to release the median nerve either wholly or partly. Sometimes it is caused because carpal tunnel syndrome was actually the wrong diagnosis, so the surgery has done nothing to relieve the symptoms. If proper diagnostic tests are done prior to the surgery this should not happen. The numbness in fingers after carpal tunnel surgery can also be because the median nerve, or indeed another nerve, is still decompressed or pinched either further up the arm or in the neck area.
After carpal tunnel surgery numbness – fingers are the usual location, but it can be in other places on the hand – which is ongoing, may take up to 12 months to resolve. On rare occasions it may never be 100% resolved but should improve a little over time.
The numbness associated with the anaesthetic administered during the surgery may last a few days. Where numbness continues for a much longer time, it is probably associated with one of the other reasons above and could take up to 12 months to resolve. In exceptional cases where the median nerve is extensively damaged, it may never totally resolve itself. If the numbness is caused by pinching of the nerve at another location, further treatment and/or surgery may be required to solve the issue.
After carpal tunnel surgery, side effects generally associated with any surgery may be experienced. These happen rarely, however it is worth noting. Some patients may have a reaction to the anaesthesia (either local or general) or some may just feel extremely tired for a few days. Any operation involves a certain amount of trauma to the body and it will need time to rest and recuperate. Although it is important to ‘keep moving’ after any surgery. doing too much too soon will have a negative effect on recovery. The occurrence of carpal tunnel surgery side effects is probably less likely than for some other surgical procedures.
According to a 2020 article in The Lancet – ‘Carpal tunnel decompression appears to be a safe operation in most patients, with an overall serious complication rate (requiring admission to hospital or further surgery) of less than 0.1%.’ So, the occurrence of carpal tunnel surgery risks and complications is extremely low, making it one of the safest medical procedures. The most frequent carpal tunnel surgery complications are neuromas (damage to a nerve), problems with the scar, abnormal sensations in the hand, joint stiffness and a failure to relieve the original symptoms.
There are a couple of reasons why people experience persistent tingling or ‘pins and needles’ as one of the side effects of carpal tunnel surgery. The first reason may be that the transverse carpal ligament has not been completely released and is still continuing to press on the median nerve. This problem tends to be more common when endoscopic carpal tunnel surgery has been performed. The second reason is because the patient has had carpal tunnel syndrome for a long time and, as a result of the long-standing compression of the median nerve, there is significantly more damage to this nerve. In extreme cases, where the nerve damage is excessive, ‘normal’ sensation in the hand may never be restored.
Joint stiffness, as one of the risks of carpal tunnel release surgery, is usually only temporary. It will happen if the patient has not been moving/exercising their fingers and hand/wrist as recommended by the medical staff post operation. It may also initially be caused by post-operative swelling. Stiffness may also be caused by pillar pain.
Rarely, one of the complications of carpal tunnel surgery is simply that it fails to relieve the original symptoms. This may occur due to a further underlying condition e.g. arthritis, because carpal tunnel syndrome was wrongly diagnosed as the problem or because the surgery failed to relieve the pressure on the median nerve. Further investigation will be needed to ascertain why the original symptoms persist and what corrective action can be taken.
Two of the carpal tunnel syndrome complications after surgery most often occurring in the 0.1% of patients who suffer complications are nerve damage and infections. We will look these now in more detail.
Nerve damage after carpal tunnel surgery, although rare, is a risk and this risk is a little higher with endoscopic surgery. Median nerve damage after carpal tunnel surgery often occurs in one of the median nerve branches. Typically, this nerve damage from carpal tunnel surgery occurs in a small ‘motor’ branch of the nerve which controls the muscles of the thumb or in the palmar cutaneous branch which controls sensations to the palm of the hand. It is worth bearing in mind that the median nerve may have been damaged, not by the surgery, but because of the fact that it has been compressed for so long.
More serious, but less likely, nerve pain after carpal tunnel surgery is connected with the ulnar nerve. The risk of damage to this nerve is extremely small. The ulnar nerve is the nerve which sends pain signals when we bang our elbow or ‘funny bone’. It travels down from the neck, through the arm and into the hand. The symptoms of ulnar nerve damage after carpal tunnel surgery are abnormal sensations in the ring and little fingers, a weakness in the fingers, a claw-like deformity of the hand and wrist and pain. Nerve damage from carpal tunnel surgery is rare and should always be thoroughly investigated.
After carpal tunnel surgery, side effects generally associated with any surgery may be experienced.
As with any surgical intervention there is always the possibility that the incision may become infected. Surgical site infections (SSIs) are fairly common in any type of surgery. Any infection that occurs at the site of a wound within 30 days of surgery is known as an SSI. During this time the body is focusing on recovering from the surgery, rather than fighting bacteria. Those patients who suffer from diabetes and/or immune deficiencies, are obese, smoke or take corticosteroids are more prone to these types of infections.
A superficial carpal tunnel surgery infection occurs in the layers of the skin around the incision. This type of infection can affect up to 5% of patients post carpal tunnel surgery but usually responds very well to a simple course of oral antibiotics.
A deep incisional infection after carpal tunnel surgery affects the deeper tissues and possibly tendons and bones. It is a very rare occurrence and may require intravenous antibiotics or even further surgery. It may cause long-term problems like stiffness.
A third category of infection – deep organ and space infection – is hardly ever heard of in carpal tunnel surgery. However, it is extremely dangerous requiring antibiotics, drainage and a second surgical procedure.
The signs of infection after carpal tunnel surgery will normally appear within 30 days of the operation. Typical signs of infection after carpal tunnel surgery include:
It is worth noting that not all of these symptoms may appear together, so any one of the above symptoms occurring within 30 days of the surgery should be treated as a potential infection symptom.
What is the success rate of carpal tunnel surgery? Long-term studies (over 2 years post surgery) put the rate of success as between 75%-90%. Although it may take several weeks to restore the ‘grip’ strength in the hand most patients will make a full recovery from carpal tunnel surgery. The success rate of carpal tunnel surgery is usually given to mean that symptoms are resolved and function has been restored.
Failed carpal tunnel surgery is rare. One retrospective study of 2,163 patients found that 3.7% of them had undergone revision surgery up to 10 years later. Carpal tunnel surgery failure, however, is most likely to occur because the median nerve has been compressed for so long that it no longer functions properly or because of a mis-diagnosis i.e. the problems are not associated with carpal tunnel syndrome.
As with any surgery there are both pros and cons of carpal tunnel surgery and every individual must consider these and the way in which they will affect their lifestyle. What is a good idea for one person is not always a good idea for another. Careful consideration and discussions with the doctor/surgeon will help with the decision of whether surgery is the correct procedure for you.
So here is a list of some of the most important carpal tunnel syndrome surgery pros and cons:
Pros
Cons
Compared to other less invasive methods carpal tunnel surgery has a very high level of success
As with any surgery undertaken there are always some minimal risks including death
Carpal tunnel surgery is a quick process usually taking just a few hours
Infections are another issue after any surgery. With carpal tunnel surgery there is also the risk that nerves in the hand may be damaged. Any underlying conditions like diabetes, obesity, high blood pressure will increase the risk factor
The recovery period is relatively short - most patients can function normally within 1-2 months
For a minority of patients the recovery time may be up to 6 months or more - and lifting heavy weights will be a problem for some time. Depending on the type of work the patient has as well as practical commitments, such a long recovery time may not be feasible
It is a relatively painless procedure and any post-surgery pain can mostly be controlled by over the counter painkillers
Although extremely rare, nerve damage can cause partial or complete paralysis of the hand. Damaged tendons will cause weakness in the hand
There is a choice of two procedures - open or endoscopic - so the surgery can be adapted to the patient’s needs
Any surgery may fail to resolve the issue and sometimes it is difficult to discover why. Damaged blood vessels and excessive scar tissue can both lead to problems later. Mis-diagnosis, where the problem is not with the carpal tunnel at all, will also mean no improvement in the condition
Can carpal tunnel come back after surgery? The short answer to this question is ‘yes’. The original carpal tunnel syndrome was probably brought on, for those people at risk, by repetitive actions and prolonged use of vibrating machinery. If there is no change in lifestyle in order to avoid these types of situations in the future then this may mean that carpal tunnel returns after surgery. According to medical literature the recurrence rate of carpal tunnel syndrome is between 3% and 25%. It must be remembered that carpal tunnel surgery may fix the problem in the immediate future but continuing to use the wrist/hand in the same way as before will just re-create the problem. No figures are available as to how much failed carpal tunnel surgery is due to the patient not following post-surgery instructions properly and how much is due to a surgical failure or simply bad luck.
Can carpal tunnel return years after surgery? There is no time limit on when the condition may or may not return. After any operation the part of the body affected will always be slightly weaker, so carpal tunnel syndrome after surgery can occur at any time. Interestingly, there is a higher percentage of recurrences in diabetic patients.
Can carpal tunnel return after surgery immediately? This is probably unlikely, although, of course, it may be that the surgery did not actually fix the problem and therefore the carpal tunnel syndrome has never actually gone away. Failed canal tunnel release does sometimes occur, albeit seldom.
When a second or subsequent operation takes place to correct the same condition, this is known, in medical terms, as revision surgery. In the majority of cases, revision surgery is not as successful as the first operation and this is no different in the case of carpal tunnel syndrome. It is estimated that up to 20% of patients get no relief from revision surgery. There are now some other techniques available for 2nd carpal tunnel surgery including hypothenar fat pad flap and research indicates that this has a higher success rate than the normal carpal tunnel revision surgery.
Some alternatives do exist when it comes to the treatment of carpal tunnel syndrome. Their effectiveness, however, depends on the severity of the condition and how receptive the patient is to these other methods. Usually, these alternatives to surgery for carpal tunnel syndrome do not have the same immediate effect that an operation does and, in most cases, relieve the condition rather than curing it. However, many of these alternatives to carpal tunnel surgery can be effective, especially in the earlier stages of the condition.
So, how to treat carpal tunnel syndrome without surgery? The biggest problem with carpal tunnel syndrome is the pain, so most carpal tunnel surgery alternatives focus on relieving the pain. This may include such simple steps as resting the hand/wrist for two weeks, no longer doing repetitive work with the hand and/or taking over the counter painkillers.
Other natural carpal tunnel alternatives to surgery have been suggested, however their efficacy has not been proven. These include increasing intake of vitamin B6 (good sources are: mangoes, bananas, avocados, brown rice and sweet potatoes) and eating pineapples (bromelain helps reduce tissue swelling). Other foods known for their anti-inflammatory properties include turmeric, cinnamon, garlic and ginger. Arnica, in a gel or cream form, is also known for its anti-inflammatory properties.
There are some other forms of relief for carpal tunnel without surgery. One such alternative is using ice packs to relieve the swelling. When it comes to carpal tunnel syndrome, cold i.e. ice packs is probably better than warm, as the cold will lessen the swelling. Other possibilities on how to fix carpal tunnel without surgery include massaging the wrists, palms and back of the hands which will aid circulation, wearing work gloves to protect the hand and wrists and using anti-vibration products when using vibrating tools.
Yoga exercises are also cited as a cure for carpal tunnel without surgery. Gentle stretching and strengthening exercises may help to reduce the pain as well as improving grip. In addition, when people are discussing how to fix carpal tunnel syndrome without surgery, ultrasound therapy is often mentioned as, by raising the temperature, it helps to reduce pain and speed up the recovery process. All of the above are frequently flagged as carpal tunnel cures without surgery, however, in reality, they do not cure, but are extremely helpful in relieving the symptoms. Let’s look at a few more ways of how to cure carpal tunnel syndrome naturally, or at least without surgery.
Some organisations promote cold laser therapy for carpal tunnel syndrome as a way of jump starting the healing process and lessening pain and discomfort. This laser therapy for carpal tunnel works by injecting photons into tissues around the area. These photons allegedly relieve pain, improve circulation and energise the cells.
The benefits of laser treatment for carpal tunnel syndrome, however, remain unproven. Research shows mixed results and there is not enough evidence available to draw any conclusions about the long-term benefits, or indeed the long-term harm, that may arise from using user therapy for carpal tunnel syndrome.
Any of the rehabilitation exercises mentioned in our section above ‘After Carpal Tunnel Surgery Exercises’ can also be used as exercises for carpal tunnel syndrome prior to surgery – as a way of relieving the pain and stiffness in the wrist. The nerve gliding exercises for carpal tunnel syndrome are very useful.
Some people ask about carpal tunnel syndrome exercises that ‘really work’. This is a difficult call to make as everyone’s body and nerve problems are slightly different. It is really a question of trying the exercises for carpal tunnel syndrome relief and discovering which exercises work best at a personal level. Any wrist exercises for carpal tunnel syndrome should help in at least partially relieving the pain, however they will need to be done persistently and consistently. Results may not be realised until after 4-6 weeks of performing the exercises.
Acupuncture does bring some relief to sufferers of carpal tunnel syndrome.
Does acupuncture work for carpal tunnel syndrome? Research in 2012, 2016 & 2017 showed that acupuncture does bring some relief to sufferers of carpal tunnel syndrome.
The benefits of acupuncture treatment for carpal tunnel syndrome are that it is very minimally invasive and also carries a very low risk. The best acupuncture points for carpal tunnel syndrome seem to be on the wrists themselves. The acupuncture appears to not only send additional blood to the area thereby helping damage nerves to heal, but also ‘remaps’ the brain so that it modifies the pain signals from the wrist. More and more evidence is emerging of the beneficial use of acupuncture therapy in chronic pain conditions and, certainly, the use of acupuncture for carpal tunnel syndrome appears to be a worthwhile and valuable addition to the list of therapies available.
A wrist splint, sometimes also known as a wrist brace for carpal tunnel syndrome, comes in slightly different shapes and sizes and can be easily bought at a local chemist or on the Internet. Sometimes, it is worth trying out different brands to find the one that is, personally, the best splint for carpal tunnel syndrome. The purpose of a wrist splint is to hold and support the wrist in a good position. As we sleep we tend to slightly flex our wrists which puts pressure on the carpal tunnel area. Wearing a wrist or hand splint for carpal tunnel syndrome will help to keep the wrist in a neutral position during those eight or so hours of sleep and may help relieve pain symptoms in mild to moderate cases. Some people also find it helpful to sometimes wear it during the day when performing actions which they know tend to aggravate the condition. There are some experts, however, who believe that wearing a splint for carpal tunnel syndrome while working is not a good idea as it may strain the hand’s tendons.
A wrist splint for carpal tunnel syndrome can be helpful in the short-term, however it can lead to muscle weakness after long-term use. After taking off the wrist brace for carpal tunnel syndrome, experts recommend performing some hand and wrist exercises to maintain the strength in the muscles.
Using the national health service of a European country, the cost of carpal tunnel surgery is often nil. However, with the health service in many countries still reeling from the effects of the recent Covid-19 pandemic, routine non-essential surgical procedures, such as carpal tunnel release, are being constantly delayed. The average cost of private carpal tunnel surgery is around £2,000, but this may not always include pre- and post-surgery consultations. The cost of endoscopic carpal tunnel surgery is very similar to the cost for open surgery. There are some people who would rather pay the carpal tunnel surgery price for private medical care, than join the waiting list for the ‘free’ treatment with the national health service.
When it comes to the cost of carpal tunnel surgery, UK prices are some of the highest in Europe. Depending on the hospital, region and surgeon the cost of carpal tunnel surgery, UK based, is somewhere between £1,010 and £2,645.
Regarding carpal tunnel surgery, NHS in line with most other national health providers offers the procedure free of charge to those eligible to use its services. Usually a GP will only refer a patient to a surgeon where other less invasive methods have been tried but the patient is still suffering with pain and discomfort. These less invasive methods may include wrist splints and steroid injections. Being referred to a surgeon does not guarantee carpal tunnel NHS surgery, only that the patient will have the opportunity to discuss his concerns with the surgeon. Ultimately it is the surgeon’s decision as to whether, on the NHS, carpal tunnel surgery is a sensible way forward for the presenting symptoms.
With the NHS still trying to recover from the Covid-19 epidemic, promises of a maximum waiting time for non-urgent surgeries of 18 weeks, is, sadly, not being met in many parts of the country. The NHS waiting time for carpal tunnel surgery, as with any non-urgent orthopaedic surgeries, can currently be much, much longer. It is worth noting, however, that patients do have the right to choose to be treated in any hospital in the NHS e.g. in England – NHS England, in Scotland – NHS Scotland etc. On occasions it may be possible to find a Trust with shorter NHS waiting times for carpal tunnel surgery, however this may mean travelling some distance.
Although the ‘European Directive Route’ for obtaining surgery paid for by the NHS within the European Union was closed after Brexit there is still an option for obtaining medical procedures through the national health services of EU members. This is called the ‘S2 Funding Route’.
The S2 funding route is only available for pre-planned surgery with the following conditions:
It may take up to 20 days for the NHS to decide if it will pay for the treatment. NHS reimbursement will reflect the country’s national health regulations regarding treatment available to its own citizens. If, for example, an EU country normally offers the surgery free to eligible citizens, then the NHS will pay 100% of the costs, if, however, the EU country normally expects its eligible citizens to pay a percentage of the costs e.g. 20%, then the NHS will only reimburse 80% of the costs. It may be possible to claim back additional payments on return to the UK.
The NHS will not reimburse travel or hotel costs and it is important to note that this offer only applies to the national health service facilities of any given country – not private medical facilities.
For those patients who wish to jump the normal waiting lists for medical treatment and pay for immediate private treatment, having surgery abroad can reduce the costs enormously. How much does carpal tunnel surgery cost overseas? Here is a list of average costs for the surgical procedure only. Travel costs and possible hotel accommodation will need to be added to these prices.
Country
Average Cost in £s
Croatia
1700
Hungary
1100
Italy
1580
Lithuania
720
Poland
460
Spain
1200
Turkey
1290
As can be seen, some very real savings can be made by going overseas for surgery even when flight costs and possible overnight accommodation is included. Although carpal tunnel release surgery only takes less than an hour, it may not be possible to fly into a country, have the surgery and fly home again all in the same day, so often one night’s accommodation will be required. Many medical centres will accept pre-surgery diagnostic tests e.g. x-rays which have been performed in the UK. What’s also important, patients can get secured for their medical trip, which makes their travel and stay abroad much safer. Clinic Hunter & AXA Partners have created a medical shield dedicated solely to medical tourists.
In many cases, Poland is an ideal country when it comes to medical treatment abroad. Its low cost of living combined with well-equipped medical centres, mean low-cost surgery in a high-tech environment. The private clinics in Poland are thriving. Equipped with the latest technology and orthopaedic surgeons trained to the highest standard, these private medical centres attract medical tourists from all over the world.
Medical tourism, Poland style, is booming as patients from western Europe, the USA and the Middle East now realise that they can expect the same level of excellent service as in their own country for a fraction of the cost. Doctors in Poland are heavily incentivised to keep up with all the latest developments and some of the best orthopaedic surgeons in the country work in these private medical centres and clinics.
Medical treatment for carpal tunnel surgery in Poland is a good choice. The cost is considerably lower than the equivalent private UK cost and there are many flights between Poland and the UK. Good value tickets are offered by the likes of WizzAir, Ryanair and Easyjet with frequent services from not only the main hub airports but also the provincial airports. Indeed, for those living near the major UK airports, it may even be possible to fly to Poland and back in one day. English is widely spoken both within the clinics and outside in the major cities.
Our consultants can provide specific details on the clinics we represent together with testimonies from other patients.
When it comes to medical tourism,Turkey is one of the front runners in the popularity polls. According to the International Medical Travel Journal (IMTJ), Turkey holds the third position in the list of countries most often visited for private medical treatment. About one third of patients treated in medical centres in Turkey are from abroad.
The cost of medical treatment in Turkey is lower than in the UK and like Poland, Turkey can offer modern treatment in state of the art clinics and hospitals. Many Turkish doctors have had experience in working in western European hospitals and, in the many private medical centres catering for overseas clients, all the staff are fluent in English.
Note that standard British passport holders may stay in Turkey for up to 90 days without a visa, but for any passport holder where a visa is required, the Turkish authorities demand medical insurance. Turkey can be reached in just under four hours and flight costs are very reasonable.
Our consultants can provide specific details of clinics in Turkey which would best suit the needs of the individual patient.
There is a huge amount of information available on the Internet including carpal tunnel release surgery reviews. It does pay to bear in mind that these reviews are completely unregulated inasmuch as anybody can write anything they want, thus it is worth comparing information from several reputable sites. We believe the websites listed below this article to be reliable. However, many more exist, and forums and blogs can also sometimes be excellent sources of first hand information. Forums under the banner of carpaltunnel.net, patient.info and diabetes.co.uk are good places to start. Links to these websites can be found in the references below.
Carpal tunnel surgery patient reviews and blogs are also an excellent source of information. These are usually written first hand by somebody who has had the surgery and knows from experience what advice worked well for them.
Many of the NHS hospital websites also have very informative reviews and information leaflets about carpal tunnel surgery available on the Internet.
Carpal tunnel syndrome is a common condition, the main cause of which is largely unknown. It is known that certain categories of people as well as certain underlying diseases sometimes trigger the condition, which is exacerbated by repetitive actions and excessive vibration to the hand. The median nerve, which runs through the carpal tunnel, becomes compressed and causes pain in the wrist, hand and certain fingers.
In mild to moderate cases this pain may be relieved by non-invasive therapy such as exercise, wrist splints, painkillers, acupuncture and steroid injections. However, if these alternative therapies do not work, then surgery is the only real answer to ‘curing’ the condition.The surgery is quick, usually 20-30 minutes and often done under local anaesthetic. Most patients will be able to resume their normal life in about one month, although it may take up to six months for the body to fully recover.
Currently, waiting lists for this type of surgery are long, and a good option is to consider private surgery overseas. Poland and Turkey are excellent choices and may represent some real cost savings over private UK treatment.
https://www.carpal-tunnel.net/forum https://patient.info/forums/discuss/browse/carpal-tunnel-418 https://www.diabetes.co.uk/forum/threads/carpal-tunnel-syndrome-painful.32541/
In the UK Anne was a professionally qualified trainer with many years of experience in the training industry. She mainly worked in the travel, tourism and leisure industries (including Thomas Cook and British Airways) as well as in other sectors.
Since moving to Poland twelve years ago, Anne has become involved in other business sectors – teaching English as a foreign language and translating documents from Polish into English. She specialises particularly, in medical translations and works closely with dentists, cardiologists and neurologists in translating and preparing articles for publication. She has also trained as a practitioner in the field of neuro-linguistic programming and is a qualified hypnotherapist.
Any spare time is spent renovating the house in Poland which Anne bought some years ago.
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