WHAT IS CARPAL TUNNEL SYNDROME?
Carpal tunnel syndrome occurs when the median nerve in the wrist becomes compressed by the transverse carpal ligament, causing tingling, numbness, waking at night, weakness or dropping objects, and sometimes discomfort in the hand.
Traditional open carpal tunnel release remains an excellent treatment. I now also offer a new minimally invasive keyhole (ultrasound-guided) option, using a 3–5 mm entry point. This technique almost always allows faster recovery, less scarring, and a quicker return to normal activity.
What Is Keyhole Carpal Tunnel Release?
Keyhole Carpal Tunnel Release is a minimally invasive surgical procedure that relieves pressure on the median nerve caused by the transverse carpal ligament. The operation is performed using
local anaesthetic only. Real-time
ultrasound guidance is used to identify the nerve and surrounding structures, allowing a fine instrument to be precisely guided through a tiny
3–5 mm entry point to divide the ligament. This highly precise method almost always allows for a faster recovery and a quicker return to normal activity compared to traditional open surgery.
Benefits:
- Very small incision
- Usually no stitches
- Minimal postoperative pain or swelling
- Return to light activities in 1–2 days
- Driving often possible after 48 hours
- Much lower infection risk
- Suitable for treating both hands at the same session
Who Is Suitable?
- Patients wanting rapid recovery
- Those with no previous wrist surgery
- Patients with normal anatomy on ultrasound
Suitability is confirmed during consultation.
Comparison With Traditional Open Release
| Benefit |
Keyhole Ultrasound-Guided Release |
Traditional Open Release |
| Incision Size |
3–5 mm entry point |
3–5 cm palm incision |
| Stitches |
Usually not needed |
Required |
| Discomfort |
Minimal postoperative pain or swelling |
Significant postoperative discomfort or scar tenderness for at least a week |
| Return to Work |
1–14 days |
3–8 weeks |
| Infection Risk |
Very low |
Higher infection risk |
| Both Hands Treated |
Suitable for treating both hands at the same session |
N/A |
| Scarring |
Minimal scarring on wrist |
Significant postoperative discomfort or scar tenderness for at least a week. |
Results and Effectiveness
Both the open and keyhole operations are highly effective in the long term (90–95% improvement or complete relief). The keyhole approach offers faster early recovery.
Recovery Timeline
Immediately:
- Begin moving your fingers
- Remove dressing next morning
- You may wash your hand the next day
- Driving often at 48 hours
1–3 days:
1–2 weeks:
- Gradual return to heavier tasks
Risks and Complications
Common to both:
- Infection (rare) with keyhole release
- Bleeding or bruising
- Temporary nerve irritation
- Incomplete symptom resolution
- Pillar pain
Open‑only:
- Tender scar
- Longer recovery
- Increased risk of Complex Regional Pain Syndrome
Keyhole‑only:
- Rare incomplete release
- Not suitable for complex anatomy or after previous wrist surgery
FAQ
- Is the keyhole operation as effective?
Yes, long‑term outcomes are equivalent.
- Will I need stitches?
Usually not.
- Can both hands be treated at once?
Yes.
- How soon can I drive?
Most patients can drive after 48 hours.
- Is nerve injury a risk?
Very low, because ultrasound guidance allows excellent visualisation.
- Does it work straight away?
Many patients experience rapid symptom improvement, although if symptoms were severe before, full nerve recovery may take weeks.
Further Information
More diagrams and postoperative advice are available at
CarpalTunnelLondon.co.uk.
