Carpal Tunnel Syndrome

A patient’s Guide

Carpal tunnel decompression surgery is a common and effective procedure for relieving the

symptoms of carpal tunnel syndrome, such as numbness, tingling, and pain in the hand and fingers. If you’re preparing for this surgery or have recently undergone it, understanding the recovery process can help you regain function, manage discomfort, and return to your normal activities with confidence.

This guide will walk you through what to expect, including timescales for recovery, pain and scar

management, and recommended exercises. There is a video of the exercises at the bottom for you to follow.

Understanding Carpal Tunnel Decompression Surgery

This surgery is performed as a day case procedure in one of the operating theatres or in a treatment room specially designed for minor procedures. It is performed under local anaesthetic, so you do not need to be starved, eat, drink and take your usual medications on the day. The area is numbed by injecting a small amount of this anaesthetic liquid at your wrist and the base of your hand. This can sting as it goes in but the stinging only lasts for a few seconds. We then clean your hand and wrist with an antiseptic liquid and cover your arm with a sterile drape. We check that the area has gone numb before we do anything and a member of staff will sit with you to ensure that you do not become distressed in any way whilst the surgery goes on.

Carpal tunnel decompression (also known as carpal tunnel release) involves cutting the transverse carpal ligament to relieve pressure on the median nerve. The surgery can be performed as an open procedure with 3 or 4 stitches and a wound of 2-3cm or minimal access using Ultrasound to guide small instruments and a tiny scar without stitches. You will usually have a padded bandage on to protect your hand for the first 2 days, but the recovery principles

are similar for both.

Take a look at my information on scar management as well.

Immediate Post-Surgery: The First Few Days

What to Expect:

Your hand will be bandaged, and you may have some swelling, bruising, and discomfort.

Your fingers may feel stiff or weak, and you may experience numbness or tingling. The local anaesthetic usually wears off within about 18 hours but during this time provides good pain relief. You can take the bandage off after 2 days. It is very unlikely that you can harm your hand by doing normal everyday activities, so don't be too scared to use your hand. The more you genlty do, the better it will recover. Make sure you touch the hand and get it used to normal feelings, different textures and temperatures - this is important feedback to your brain as the nerve recovers.

The pain, pins and needles and tingling that you had before the operation usually disappear very quickly, in a few days.

If you had permanent numbness in the fingers before the operation this may improve much more slowly, over months.

Pain Management:

For most people, Paracetamol and Ibuprofen give enough pain relief. 

Keep your hand elevated above heart level as much as possible to reduce swelling.

Apply an ice pack (wrapped in a towel) for 10-15 minutes at a time, several times a day.

Scar Care:

Keep the wound covered with a dressing for at least 5 days. If after this it is dry and the wound healing well, you can leave it uncovered if you want to do so.

Avoid soaking your hand in water (no baths or swimming), but after 5-7 days, if it gets wet, just pat it dry, making sure it is clean until the sutures are removed.

First Week: Early Recovery

Movement and Activity:

Begin gentle finger movements as soon as possible to prevent stiffness.

Avoid heavy lifting, gripping, or twisting motions.

You can do normal daily activities as pain allows.

Watch for signs of infection: increased redness, swelling, warmth, or discharge.

Exercises:

Gently bend and straighten your fingers several times a day.

Touch your thumb to each fingertip in turn.

Make a gentle fist and then release.

1-2 Weeks: Stitches and Early Healing

Stitches Removal:

Stitches are usually removed 10-14 days after surgery (if not dissolvable).

Once stitches are out and the wound is healed, you can start gentle washing and moisturizing.

Regaining Movement:

Continue finger exercises.

Start gentle wrist movements as comfort allows.

Avoid forceful gripping or weight-bearing.

Scar Management:

Once the wound is closed, gently massage the scar with a non-perfumed moisturizer or vitamin E oil, Bio-oil or silicone scar gel. Massage in circular motions for a few minutes, 2-3 times daily, to soften the scar and prevent adhesions.

Driving:

You can usually return to driving when you can grip the steering wheel comfortably and perform

an emergency stop safely—typically 1-2 weeks after surgery.

2-6 Weeks: Building Strength and FunctionReturning to Daily Activities:

Light activities such as eating, dressing, and typing can usually be resumed within 2 weeks,

depending on comfort.

Avoid heavy lifting, forceful gripping, or repetitive wrist movements.

The most common problem that people experience is tenderness around the scar, especially

near the wrist. We call this “Pillar pain”. It settles with time, and scar management techniques.

Returning to Work:

Desk-based or light duties: 2-3 weeks, depending on pain and function.

Manual or heavy work: 6-8 weeks, depending on recovery and job demands.

Discuss your specific job requirements with us provider for tailored advice.

Exercises:

Continue finger and wrist exercises.

Add gentle resistance exercises using a soft ball or putty (squeeze and release).

Practice wrist flexion and extension: rest your forearm on a table, palm down, and gently lift and

lower your hand.

6-12 Weeks: Regaining Strength and Confidence

Movement and Strength:

Most patients regain significant movement and strength by 6-8 weeks.

Some residual weakness or discomfort may persist, especially with heavy use.

Daily Activities:

Gradually increase activity levels as tolerated.

Resume hobbies and sports as comfort allows, but avoid high-impact or repetitive activities until

cleared by your surgeon.

Scar Management:

Continue regular scar massage.

Protect the scar from sun exposure to prevent darkening.

Pain Management:

Occasional aches or twinges are normal but should gradually improve.

If pain persists or worsens, contact us.

3-6 Months: Full RecoveryStrength and Function:

Most people achieve full recovery within 3 months, though some may take up to 6 months for

complete strength and sensation to return.

Persistent numbness or weakness may occur, especially if nerve compression was severe or

longstanding before surgery.

Returning to All Activities:

By 3 months, most patients can return to all normal activities, including sports and manual work.

Continue exercises to maintain flexibility and strength.

Frequently Asked Questions

How long will I have pain after surgery?

      Mild to moderate pain is common for the first few days to weeks. Most people find     pain improves significantly after 2-3 weeks.

When can I use my hand normally again?

       Light activities can usually be resumed within 2-3 weeks. Full strength and function may take up to 3 months.

Will I have a scar?

       Yes, but with proper care, the scar usually fades and softens over time.

What if my symptoms don’t improve?

      Some numbness or weakness may persist, especially if nerve compression was severe. If you’re concerned, discuss this with me.

Conclusion

Recovering from carpal tunnel decompression surgery is a journey that requires patience, self-care, and gradual return to activity. By following advice, practicing regular exercises, and managing pain and scars effectively, you can maximise your recovery and return to the activities you enjoy. If you have any concerns or your recovery isn’t progressing as expected, don’t hesitate to reach out to us for support.