Carpal Tunnel Syndrome

Are you waking up most nights with all your fingers except your little finger numb? Do you shake them and clench them to get your feeling back? Chances are that you have carpal tunnel syndrome caused by median nerve compression at the wrist. A cortisone injection will often solve the problem temporarily and sometimes long term. The operation of carpal tunnel decompression is the definitive fix. 

I most often treat carpal tunnel syndrome under local anaesthetic at my rooms. If the idea of being awake while it is done doesn’t appeal the surgery can be done under general anaesthetic as a hospital day case. If it is work-related you may be able to access ACC funding.

For about ten years I did about half of these operations endoscopically but gradually phased it out in favour of the direct method which requires much less equipment and expense. I wasn’t convinced that the endoscopic method was sufficiently better to justify the increased complexity.

It’s a common condition, easily diagnosed and easily fixed.  Ideally you should have the procedure before you have any numbness persisting right through the day – for then complete recovery of sensation, day and night, is immediate.  If your hand does not recover fully during the day your immediate result will be only as good as that and it will take 6 to 12 months for, hopefully, full recovery.

For two days your hand is bandaged but with your fingers free. After that you have only a piece of tape on the stitches at the base of the palm and you can shower normally.  Stitches are removed at two weeks.  From the beginning you can do with your hand whatever it will let you do. You will be limited by pain at the base or your palm and have temporary loss of quite a lot of grip strength. Tenderness at the base of the palm and grip strength gradually recover over 3 to 6 weeks. How much time you need off work depends on how hand-intensive your occupation is. If time off work is an important issue and you need both hands done, they can be done at the same time without leaving you helpless!


  • It is rare for the symptoms of carpal tunnel syndrome not to resolve completely – other than residual numbness if the condtion has been allowed to progress too far.   Severe cases may have paralysis of the muscles at the base of the thumb so that you can no longer lift it out of the plane of the palm.  In severe cases this paralysis may not recover.
  • Very rarely a tender point (neuroma) develops in the scar at the base of the palm – perhaps 5 times in a thousand cases.   This can usually be fixed by excision of the scar. 
  • The risk of nerve injury is exceedingly small.
  • See risks common to all operations.

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