Surgery for carpal
tunnel syndrome

Is surgery right for carpal tunnel syndrome?

Surgery is not the right fit for everyone, but it can be a helpful option when the median nerve in your wrist is under too much pressure and symptoms are not improving.

Surgery might be considered for carpal tunnel syndrome if:

• Your numbness, tingling, or pain is still disrupting sleep and daily life after trying strong non-surgical care.¹ ²
• You are starting to notice weakness in your thumb or clumsiness, like dropping objects or struggling with buttons.²
• You have constant numbness or visible muscle loss at the base of your thumb.²
• Nerve tests show more severe nerve irritation or damage, and your care team is concerned about long-term recovery.³

It also helps to know this: deciding on surgery is a shared decision. Some people want faster relief to keep working or sleeping. Others prefer to try more conservative care first. A clinician can help you weigh what matters most to you, based on your symptoms, exam findings, and test results.² ⁴

Common surgical options for carpal tunnel syndrome

These procedures are all designed to take pressure off the median nerve by releasing the tight band of tissue over the carpal tunnel.

Open carpal tunnel release

• A small incision is made in the palm, and the ligament over the tunnel is released.
• Often chosen because it is widely available and works well long term.⁵

Endoscopic carpal tunnel release

• Uses a small camera and instruments through a tiny incision (or incisions) to release the same ligament.
• Often discussed when faster early return to function is a priority, depending on surgeon experience and your needs.⁵ ⁶

Revision carpal tunnel release

• A repeat surgery for people whose symptoms return or never fully improved after a prior release.
• Less common, and usually considered only after careful testing to confirm the cause.⁴

What to expect during recovery

Recovery is different for everyone, but many people notice nighttime tingling and numbness improve fairly quickly after the pressure is relieved. How fast strength returns depends on how long the nerve has been irritated and whether there was muscle weakness before surgery.² ⁴

What recovery often looks like:

• First few days: soreness in the palm or wrist, swelling, and stiffness. You will usually be encouraged to move your fingers early to prevent stiffness.²
• First 1 to 2 weeks: many people can do light daily tasks, like eating, dressing, and typing short periods, but gripping and pushing can feel uncomfortable.⁵
• Next several weeks: strength and endurance build gradually. Jobs that require heavy gripping, vibration tools, or forceful hand use usually take longer to return to.⁵ ⁶

Common challenges:

• Tenderness at the incision site, and aching at the base of the palm, especially early on.⁵
• Temporary nerve irritation, like sensitivity or tingling during healing.⁵ ⁶

Risks to know about (rare, but real):

• Infection, bleeding, scarring, stiffness, or ongoing symptoms if the nerve was already badly affected.² ⁵
• In some cases, symptoms can return over time or may not fully resolve, especially if there are other nerve problems involved.⁴

Surgery (both open and endoscopic) approaches tend to have similar long-term results, but endoscopic release may allow faster early recovery for some people.⁵ ⁶ The best approach is usually the one your surgeon does well and recommends for your situation.²

Can surgery be avoided?

Often, yes. Many people with mild to moderate carpal tunnel syndrome improve with conservative care, especially if symptoms are mostly at night or come and go. Night splints and activity changes can reduce pressure on the nerve and help you sleep.⁷

Two common options that may help you avoid or delay surgery:

• Night splinting: Wearing a neutral wrist splint at night can improve symptoms compared with no treatment, and it is low risk.⁷
• Steroid injection: A single injection can bring faster short-term relief than splinting, but symptoms may return over time, and some people later choose surgery.¹ ⁸

If you want to explore conservative care first, see more in our guide to physical therapy for carpal tunnel.

How Sword can support you before and after surgery

Physical therapy can play an important role in preparing for surgery, supporting recovery, and, in some cases, helping people manage symptoms without surgery. Sword offers physical therapy programs designed to support you at different points along that journey.

Sword supports recovery before and after surgery, with care designed to fit into your life. You receive high-quality physical therapy at home, guided by licensed clinicians and supported by smart technology.

• Care that adapts as your body and recovery needs change
• Licensed physical therapists guiding your care at every stage
• Non-invasive, evidence-based physical therapy programs

Support for preparation, recovery, and long-term movement health

Clinical insight

The American Academy of Orthopaedic Surgeons emphasizes matching treatment to the person, not forcing a one-size-fits-all path. Non-surgical options like splinting and steroid injection can be appropriate for mild to moderate symptoms, while surgery is strongly considered when symptoms persist, function is limited, or there are signs of nerve damage.²