The carpal tunnel is a narrow passageway in the wrist formed by bones and a ligament. It houses the median nerve and several tendons that extend to the fingers. Carpal tunnel syndrome occurs when the median nerve becomes compressed within this tunnel, leading to symptoms such as pain, numbness, tingling, and weakness in the hand and fingers, particularly the thumb, index, middle, and part of the ring finger. Carpal tunnel release surgery aims to alleviate this pressure by cutting the transverse carpal ligament, which forms the roof of the carpal tunnel, thereby creating more space for the nerve. This procedure is considered when non-surgical treatments have not provided sufficient relief or when symptoms are severe.
Immediate Post-Surgery Hand Use
Immediately after carpal tunnel surgery, the hand will be wrapped in a bandage or splint to protect the incision and stabilize the wrist. Patients may experience mild pain, discomfort, and swelling in the hand and wrist. Elevating the hand above heart level is recommended to help reduce swelling and discomfort during the initial days of recovery.
While the wrist is kept immobile, gentle movement of the fingers and thumb is encouraged, starting on the day of surgery. These early, light movements help prevent stiffness and promote circulation. Gripping activities, heavy lifting, or activities that could strain the wrist should be avoided during this immediate post-operative period. The initial bandage or splint remains in place for one to two weeks, after which it is removed.
Gradual Return to Activity
The progression of hand use after carpal tunnel surgery is gradual. Two to four weeks post-surgery, individuals may begin to resume light daily activities such as eating, dressing, or light typing. Avoid activities that involve strong gripping or lifting objects heavier than one to two pounds during the first few weeks. Driving can resume around two weeks after surgery, though this can vary based on individual recovery and whether the dominant hand was operated on.
More strenuous activities, including heavy lifting, gripping, or repetitive hand motions, should be avoided for at least four to six weeks for proper healing. Returning to work depends on the job’s demands; desk-based roles can be resumed within one to two weeks with modifications, while jobs requiring manual labor or repetitive motions may require six to eight weeks or longer off. Throughout this period, listening to the body and avoiding any activity that causes pain or strain is important for recovery.
Rehabilitation for Full Function
Rehabilitation plays a key role in regaining hand function after carpal tunnel surgery. Physical or occupational therapy begins once the initial splint or bandage is removed, within one to two weeks post-surgery. These therapy sessions aim to improve strength, flexibility, and mobility of the hand and wrist. Specific exercises, such as nerve gliding, ensure the median nerve moves freely within the carpal tunnel and prevent scar tissue from adhering to the nerve.
Range of motion exercises for the wrist and fingers also help prevent stiffness and restore flexibility. As recovery progresses, strengthening activities begin to rebuild strength in the hand and wrist, which can take several months to return fully. Adhering to the therapist’s guidance and consistently performing prescribed exercises are important for optimizing long-term recovery and returning to daily activities.
Monitoring Your Recovery Progress
Monitoring recovery progress involves recognizing healing signs and potential warning signs. Signs of healing include a gradual decrease in pain and discomfort, improved sensation in the fingers, and increasing strength in the hand and wrist. While some soreness in the palm or sensitivity to pressure may persist for several weeks, these symptoms should gradually diminish. Many patients experience immediate relief from numbness and tingling after surgery, though full resolution of symptoms can take time.
Contact a healthcare provider if warning signs appear. Warning signs include:
- Persistent or worsening severe pain not managed by medication.
- New or increasing numbness or weakness.
- Signs of infection such as increased redness, warmth, swelling, pus, or fever.
- Continuous bleeding.
- A cool or pale hand.
- A tight splint.
- Symptoms do not improve as expected.