Carpal tunnel syndrome affects the hand and arm, causing numbness, tingling, and pain due to compression of the median nerve in the wrist. This condition arises when swelling or other factors reduce the space within the carpal tunnel, a narrow passageway of bones and ligaments in the wrist. When non-surgical treatments are insufficient, carpal tunnel release surgery becomes an option to alleviate pressure on the median nerve.
Immediate Post-Surgery Period
Immediately following carpal tunnel release surgery, the primary focus is on protecting the surgical site and managing initial discomfort. The hand will typically be bandaged or splinted for several days to about two weeks to immobilize the wrist and support healing. Pain and swelling around the incision are common, and these can be managed with prescribed pain medication and by elevating the hand above heart level. Moving the fingers and hand as soon as possible is encouraged to prevent stiffness and promote circulation.
During the first few days, activities are extremely limited to allow the incision to heal. Very light activities, such as wiggling fingers, can begin almost immediately to prevent stiffness and reduce swelling. Avoid gripping, lifting, or repetitive motions, as these can strain healing tissues. Keeping the surgical site clean and dry is crucial for preventing infection.
Gradual Return to Activity
As initial healing progresses, typically from one to six weeks post-surgery, hand use can gradually increase. Around 10-12 days, sutures may be removed, and hand therapy might begin to reduce stiffness and restore range of motion. Light daily activities such as eating, dressing, and light typing can often be resumed within the first few weeks, usually around two to four weeks, provided they do not cause pain.
Driving may be considered safe around two weeks after surgery, though this varies by individual recovery and medication use. Gentle range-of-motion exercises, including wrist flexion and extension, are often introduced to improve flexibility and prevent scar tissue from restricting movement. It is important to avoid any activities that cause discomfort or pain, as pushing too hard can hinder recovery.
Long-Term Recovery and Rehabilitation
Beyond six weeks, recovery shifts towards regaining full strength and function. While significant improvement is seen within three to four months, complete recovery and hand strength return can take up to a year. Physical or occupational therapy plays a central role during this phase, focusing on strengthening exercises, improving grip, and enhancing fine motor skills. Therapists guide patients through exercises like grip strengthening and wrist rotations.
Scar management, including gentle massage, is important to improve flexibility and reduce pain from scar tissue formation. Nerve gliding exercises, which gently move the median nerve, are introduced to prevent adhesions and restore nerve mobility. Returning to more demanding activities, sports, or work-related tasks typically occurs between six to twelve weeks, though it can extend longer based on individual progress.
What to Watch For
While carpal tunnel surgery is generally safe, be aware of warning signs that may indicate complications. Persistent or worsening pain not alleviated by medication, or severe pain that does not improve, warrants immediate medical attention. Signs of infection, such as increased redness, warmth, swelling, pus draining from the surgical site, or a fever, should be reported to a healthcare provider without delay.
Other symptoms to watch for include continuous bleeding, a rash or allergic reaction, new or worsening numbness, tingling, or weakness in the hand or fingers, and a sudden loss of hand function. If symptoms fail to improve or worsen, or if persistent swelling does not subside, contact your surgeon or healthcare provider for an evaluation.