What is a carpal tunnel release?

Carpal tunnel release is a surgery to treat carpal tunnel syndrome. Carpal tunnel syndrome is a common disorder caused by compression of the median nerve in the wrist. It can lead to pain, numbness, and sometimes disability of the hands. Carpal tunnel release involves relieving pressure on the median nerve by cutting part of the carpal ligament. This band of tissue holds the wrist joint together.

Carpal tunnel release is a common surgery but has risks and potential complications. Your doctor will probably recommend less invasive treatment options for carpal tunnel syndrome before considering carpal tunnel release for you. Consider getting a second opinion about all of your treatment choices before having a carpal tunnel release.

Why is a carpal tunnel release performed? 

Your doctor may recommend a carpal tunnel release to treat carpal tunnel syndrome. Carpal tunnel syndrome is often associated with repetitive actions of the hands and wrists. Examples include long-term keyboarding, use of vibrating tools, or assembly line jobs. 

These actions can cause swelling and increased pressure on the median nerve over time. This can lead to pain and numbness that can become disabling. Other conditions that are linked to carpal tunnel syndrome include diabetes, pregnancy, menopause, a hand or wrist injury, and rheumatoid arthritis. 

Doctors generally do not consider carpal tunnel release surgery unless less invasive treatments have been ineffective. Ask your doctor about all of your treatment options and consider getting a second opinion before deciding on carpal tunnel release. Other treatments include:

  • Acupressure and acupuncture, which may help reduce pressure on the median nerve
  • Anti-inflammatory medications, including nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin) and aspirin. NSAIDs treat carpal tunnel syndrome effectively, but long-term use can cause serious side effects. These include bleeding stomach ulcers and kidney problems. You should only take NSAIDs as directed by your healthcare provider. 
  • Changing or limiting repetitive motion or jarring activities of the hands and wrists. These include typing, keyboarding, sewing, performing dental work, and using a chainsaw or jackhammer.
  • Corticosteroids to reduce the inflammation and pain of carpal tunnel syndrome. Corticosteroids are usually given through an injection into the carpal tunnel of the wrist. 
  • Ensuring that keyboards are placed low enough so that wrists are not flexed while working
  • Not flexing the wrists for long periods of time. For example, your doctor may recommend that you wear a wrist brace at night to prevent your wrists from flexing while you are sleeping.
  • Seeking regular medical care and following your treatment plan for underlying conditions. Conditions include acromegaly, diabetes, hypothyroidism, pregnancy, rheumatoid arthritis, and hand and wrist trauma and fractures.

Who performs carpal tunnel release?

The following specialists perform carpal tunnel release:

  • Hand surgeons specialize in medical and surgical treatment of the structures of the hand, wrist, forearm and elbow.
  • Neurosurgeons specialize in the medical and surgical care of diseases and conditions of the brain and nervous system.
  • Orthopedic surgeons specialize in the medical and surgical treatment of diseases and conditions of the bones, muscles and joints.
  • Plastic surgeons specialize in using surgery to correct conditions that affect a person's ability to function or appearance.

How is carpal tunnel release performed?

Your carpal tunnel release will be performed in a hospital or outpatient setting. It is usually an outpatient surgery.

Your surgeon will make an incision in the wrist and cuts into the carpal ligament. This enlarges the space in the carpal tunnel and relieves pressure on the median nerve. The surgery takes about an hour, depending on the surgical approach. 

Surgical approaches to a carpal tunnel release 

Your surgeon will perform your carpal tunnel release using one of the following approaches: