Current waiting time: 4 weeks to assessment
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Carpal Tunnel Syndrome (CTS) is a relatively common condition that causes pain, numbness and a tingling sensation in the hand and fingers. Usually, these sensations develop gradually and start off being worse during the night. They tend to affect the thumb, index finger, middle finger and half of the ring finger.
Other symptoms of CTS include pins and needles (paraesthesia), thumb weakness, a dull ache in the hand or arm.
Surgery is usually only recommended for severe cases of CTS when symptoms last for more than six months or other treatments have not been effective. Surgery for CTS is known as Carpal Tunnel Decompression or Carpal Tunnel Release and is performed on an outpatient basis, which means you will not have to stay in hospital overnight.
During surgery the roof of the carpal tunnel, known as the carpal ligament, is cut to reduce pressure on the median nerve in the wrist. A local anaesthetic is used to numb your hand and wrist but you will remain awake throughout the operation. The surgery is performed at N2S as open surgery, which involves making a single cut in the wrist and is the traditional type of operation.
Following your surgery your hand will remain in a bandage and you will need to wear a sling for 48 hours. Keeping your arm raised in the sling will help reduce any swelling and stiffness in your fingers. You will be shown exercises for your fingers and thumb, which will need to be performed frequently to avoid any stiffness. Other instructions will be included in your post-operative instruction pack, which will be handed out on the day of your surgery.
There are alternative treatments, which will be discussed during an initial assessment appointment with your consultant. They may offer you a steroid injection during this assessment, if they feel this is an appropriate treatment for your condition.
Typical Patient Jouney
Step 1: Referral
Referral agreed during an appointment with your GP, which will be sent electronically to N2S via the NHS Electronic Referral System (e-RS).
The N2S Administration Team will then add your referral to the waiting list and an appointment for assessment with a Consultant Hand Surgeon.
Current wait for assessment – 4 weeks
A letter will be sent out with an assessment appointment when you get nearer to the top of the list. During your assessment appointment you will discuss your case with a Consultant Hand Surgeon. If decided that surgery is the next step you will then be added to the waiting list.
Step 2: Procedure – what to expect on the day
On the day of surgery you will be with us for no longer than 1 hour and the procedure itself should not take more than 15 minutes. You will not be able to drive home so please make arrangements for this.
Depending on your Covid status we may ask you to take a test. You will be escorted to an allocated area where you will be checked in.
You will be called to theatre by the theatre team who will check your details before starting.
Please wear loose clothing around the arm we are operating on so the tourniquet can be applied.
Step 3: Post-op
What to expect
- You can remove the outer bandage 2-3 days after your surgery, but the sticky dressing needs to remain in place until you have had your stitches removed 14 days post operation.
- Should the dressing become loose or wet, replace with a similar breathable dressing. These are easily available at high street pharmacies.
- You will be shown hand exercises after your operation. After the removal of the outer bandage you should try and make a fist. Continue with hand exercises until after your stitches are removed, at which point you will be given further exercises to do.
- After your stiches are removed you should massage the wound with Bio Oil or E45 cream 4 times per day to aid healing.
- You will receive a telephone review 6 weeks post operation – it is important you’re able to take this call so that we can discharge you/arrange for any further treatment appropriately.
PLEASE REMEMBER IT CAN TAKE UP TO 6 MONTHS FOR YOUR HAND TO FULLY HEAL.
Hand surgery FAQ
When can I drive?
DO NOT DRIVE until the removal of stiches at 2 weeks post operation.
Do I need someone to take me home after the operation?
We would like someone to take you home, alternatively you could get a taxi. Public transport is not advisable.
Can I have my stiches removed at my GP Practice ?
No, our policy is to have your stitches removed by the clinicians at N2S.
When can I bathe or shower?
You should cover your bandage securely with a plastic bag in order to bathe or shower.
Can I have my stitches removed earlier or later than instructed?
No, they must be removed 14 days after the operation; too soon and the wound might not fully heal, too late and the stitches can become too tight.
When can I go swimming?
Avoid swimming for three weeks post operation.
When can I resume sports activity?
Avoid sporting activities for at least 6 weeks.
How long do I need to stay at home from work?
The length of time depends on the type of work you do. N2S can issue a sick certificate for 2- 4 weeks, this must be signed by the surgeon so please prompt the team on the day of your operation.
Will my hand be painful?
When the anaesthetic wears off your hand will be throb; this is normal. Take painkillers (e.g. paracetamol) regularly for the first 48 hrs as directed on the packaging.
Steroid Injections during Covid-19
If you have any questions, please get in touch: