Private Carpal Tunnel Release Surgery

Carpal tunnel syndrome (CTS) is one of the most common nerve compression conditions in the UK, affecting millions of adults. It occurs when the median nerve — which runs through a narrow passage in your wrist called the carpal tunnel — becomes compressed or squeezed.

This ‘tunnel’ houses both the median nerve and nine tendons controlling finger movement. When pressure builds within this confined space, it disrupts nerve signals travelling to your hand and fingers. CTS affects women more frequently than men and is particularly prevalent in people aged 40–60. It can occur in one or both wrists.

When left untreated, carpal tunnel syndrome can cause permanent nerve damage and significant loss of hand function, making early diagnosis and treatment essential.

Carpal tunnel syndrome is caused by increased pressure on the median nerve within the wrist. Several risk factors are associated with its development, including:

• repetitive hand and wrist movements
• prolonged use of vibrating tools
• sustained awkward wrist positions – common in office workers, manual labourers, and musicians.

Medical conditions significantly linked to CTS include:

• diabetes
• rheumatoid arthritis
• hypothyroidism
• obesity
• pregnancy
• hormonal changes during the menopause can also increase risk.

In many cases, no single cause is identified. NICE guidelines recognise that carpal tunnel syndrome is often multifactorial, involving a combination of anatomical, occupational, and health-related contributors. Understanding the underlying cause helps guide the appropriate treatment.

Diagnosis of carpal tunnel syndrome is based on your symptoms and also a physical examination. One of our Consultant Orthopaedic Surgones will assess sensation, grip strength, and perform certain tests, including Tinel’s sign (tapping over the wrist) and Phalen’s manoeuvre (sustained wrist flexion).

In line with NICE guidelines, nerve conduction studies (NCS) are the gold standard confirmatory test, measuring the speed of electrical signals along the median nerve to quantify the degree of compression. You can find out if you are suitable for a Nerve Conduction Study here.

Ultrasound imaging can also be used to assess the nerve and exclude other causes.

Carpal tunnel syndrome symptoms typically develop gradually and are often worse at night. The most common symptoms include:

• Tingling
• Numbness
• Pain in the thumb, index, middle, and part of the ring finger
• Burning or aching sensation radiating from the forearm
• Weakness of the grip, dropping objects
• Difficulty with fine motor tasks such as fastening buttons
• stiffness in the morning
• needing to shake your hands to relieve discomfort

Symptoms are frequently aggravated by activities involving prolonged wrist flexion – such as driving, reading, or using a keyboard.

If you recognise these carpal tunnel syndrome symptoms, early assessment is recommended to prevent any longer term issues from arising.

Carpal tunnel release surgery — also known as carpal tunnel decompression — is a safe and highly effective procedure recommended by NICE for moderate-to-severe or treatment-resistant carpal tunnel syndrome.

It is typically performed as a day-case procedure under local anaesthetic, meaning you remain awake but your hand is completely numb. Your surgeon makes a small incision in the palm of your hand to divide the transverse carpal ligament, widening the carpal tunnel and relieving pressure on the median nerve. The procedure takes around 30 minutes. Both open and endoscopic (keyhole) techniques are available. Surgery has excellent long-term outcomes, with the majority of patients experiencing significant or complete relief of symptoms. It is widely considered the most effective long-term treatment for carpal tunnel syndrome.

Recovery after carpal tunnel release surgery is generally straightforward. Your hand will be bandaged following the procedure, and most patients are discharged the same day. Mild discomfort, swelling, and bruising are normal in the first one to two weeks. You should keep the wound clean and dry until sutures are removed, typically at 10–14 days. Light hand use is usually possible within days, with a return to desk-based work often achievable within two weeks. More physically demanding work may require four to six weeks of recovery.

Numbness and tingling frequently improve within weeks, though full nerve recovery can take several months in longstanding cases. NICE recommends physiotherapy if recovery is slower than expected.