Carpal tunnel syndrome occurs when the median nerve in your wrist is compressed or squeezed repeatedly over a period of time, resulting in pain, numbness, and tingling in your fingers and hands. A carpal tunnel release, also known as open tunnel release, is a surgical procedure aimed at treating carpal tunnel syndrome. 

It is uncommon for a carpal tunnel release to be performed as the first mode of treatment. Your orthopaedic surgeon will only resort to surgical intervention if the condition has progressed to an acute stage of carpal tunnel syndrome. By this stage, one is usually unresponsive to treatments such as immobilisation through splints or corticosteroid injections with persistent symptoms such as pain and numbness. If left untreated, carpal tunnel syndrome can lead to permanent dysfunction of the arm associated with weakness and reduced motor and sensory capabilities. 

Following your orthopaedic evaluation, imaging tests such as x-rays and magnetic resonance imaging (MRI) will be conducted to confirm surgery suitability. A surgery date will then be assigned.

During the surgery, incisions are made near the wrist to access the carpal tunnel. Ligaments and tissues enveloping the carpal tunnel are subsequently removed to create space for the nerve to function. If any bone spurs are found as the root cause of compression, these would be removed as well. 

Fundamentally, the surgery involves removing the source of medial nerve compression that is causing dysfunction. When the median nerve is sufficiently mobilised, the site of surgery is thoroughly cleaned. Finally, incisions are closed with sutures.  

• Dexterity is improved and salvaged 
• Arm functionality is recovered 
• Nerve preservation 
• Relief from symptoms of pain 
• Improved quality of life 

Carpal tunnel release can be used to treat the following conditions:

• Complications from pregnancy: excessive fluid retention during pregnancy can lead to carpal tunnel syndrome. 
• Arthritis: arthritis such as osteoarthritis or inflammatory arthritis could result in bone spurs or swelling of the carpal tunnel which subsequently results in compression. 
• Post-traumatic carpal instability: prior injuries such as fractures would make one prone to carpal instability.
• Congenital abnormalities: recent studies have indicated that some patients are born with smaller carpal tunnels or enlarged ligaments which causes increased compression of the medial nerve. 
• Metabolic disruption: metabolic conditions such as obesity, metabolic syndrome, and menopause increases the risk of carpal tunnel syndrome due to structural anatomical changes that take place. 

Carpal tunnel release has a success rate of up to 90% indicating that this surgical procedure is effective in providing release and alleviating symptoms caused by carpal tunnel syndrome. Additionally, high satisfaction is also noted by patients. One can expect physical relief following a carpal tunnel release and improved quality of life. 

Typically, one would gain range of motion within 4 months but full recovery of strength could take up to a year. Recovery time may differ according to the severity of the condition and the promptness in addressing the condition. 

It is important to note that treatment does not end at surgery. One has to address the weakness of the arm and limited range of motion sustained from carpal tunnel syndrome through a dedicated regime of physiotherapy. 

Diets and post-surgical habits could also impact your healing rate. With positive post-surgical care and collaborative work with your orthopaedist (link to about us), a positive outcome can be anticipated. 

Your orthopaedist can give you a better idea of what to expect based on your individual needs and circumstances. 

Carpal tunnel release is a one-off surgery. It is significantly rare that one requires secondary surgery. In the event a revision is necessary, it is most likely due to failure of prior surgery, described as an incomplete carpal tunnel release. Other factors could include the recurrence of local compression such as new bone spur growth or fluid retention. Practising poor lifestyle choices such as continued weight gain may also lead to subsequent carpal tunnel release surgeries. 

It is important that patients maintain good post-surgical care and precaution to ensure continued improvement of their condition. To attain a successful recovery, one will need to attend physiotherapy sessions and appropriately manage medication. The frequency of physiotherapy sessions will vary according to your condition.