When Is It Time for Carpal Tunnel Surgery?

Carpal tunnel syndrome is a painful condition that affects the wrist, hand, and arm. It occurs when the median nerve in the wrist becomes pinched. This major nerve is responsible for providing muscle function and sensation to the hand and fingers. Carpal tunnel syndrome symptoms include tingling and pain in the thumb and first three fingers, numbness and a burning sensation that travels up the arm.

The treatment for carpal tunnel syndrome will vary from one patient to another, depending on the duration and extent of the condition. For minor cases characterized by only slight numbness, simply shaking or moving the arm can provide some wrist pain relief. However, other patients will need wrist splints or steroid medications such as corticosteroids to help relieve symptoms. While there are also cases, where surgery is the best option for long term relief.

For patients suffering from carpal tunnel, the providers at Fitzmaurice Hand Institute knows that understanding when it is time for surgery can be confusing or even scary. As one of the most renowned hand surgery experts in the world, Dr. Fitzmaurice and his medical care team has extensive knowledge and expertise in treating carpal tunnel syndrome. In this blog, he shares his knowledge of carpal tunnel to help patients in the Phoenix Metropolitan area and across the country who might need or are considering treatment for carpal tunnel.

When Should Carpal Tunnel Surgery Be Considered?

In a nutshell, carpal tunnel surgery is recommended:

  • When wrist splints, corticosteroid, physical therapy or even stem cell treatments don’t work, surgery will be recommended.
  • If the patient still suffers from symptoms after several weeks and months of trying all the available nonsurgical treatment options, surgery will usually be the only alternative.
  • When the pain is hampering the patient’s daily activities, or there is persistent loss of feeling or coordination in the fingers or hand.
  • Nerve tests clearly indicate damage to the median nerve, surgical remedy would be the obvious solution for treatment as well as for preventing permanent nerve damage. Ultrasound is an alternative that improves moderate to severe carpal tunnel.

Research has demonstrated that results after surgery are better if treated earlier than later. For example, the fingers could weaken until they become unusable. Which is why patients with carpal tunnel are encouraged to seek treatment before their symptoms become debilitating.

What Is The Goal Of Carpal Tunnel Surgery?


The goal of performing carpal tunnel surgery is to relieve pressure on the median nerve. This can be accomplished by cutting or releasing the transverse carpal ligament in the palm of the hand. A successful surgery is not only dependent on cutting this ligament to ensure pressure relief, but also being able to avoid causing harm to nearby structures. When performed by an expert hand surgeon, damage to any surrounding tissue can be avoided and will help speed up recovery time.

What Are The Surgical Options for Carpal Tunnel?

There are two possible procedures when surgery is considered:

Open Carpal Tunnel Surgery

In this procedure, a surgeon makes an incision on the inside of the wrist. This will release pressure on the median nerve, relieving the symptoms of carpal tunnel syndrome. The surgeon will then make an incision on the base of the palm. This opening allows the surgeon to see and cut the transverse carpal ligament. After cutting the ligament and releasing the underlying pressure, the incision is closed with stitches. The cut ligament gap is left open to be eventually filled up with scar tissue.

Open carpal tunnel surgery is performed under local  or general anesthesia, depending on the doctor. After surgery, the hand will be wrapped. Patients are discharged the same day and will return in 2 weeks to have stitches removed. Pain and discomfort should subside within 6-8 weeks.

EndoTech® Carpal Tunnel Surgery

Invented by Dr. Fitzmaurice of the Fitzmaurice Hand Institute, EndoTech® is a revolutionary procedure that uses cutting-edge technology and a precisely engineered operating system that allows for tiny incisions, better visibility, minimized trauma and higher patient safety. This also means less pain and downtime, plus faster recovery.

During the procedure Dr. Fitzmaurice will use a thin, flexible tube (endoscope) which comes with an attached tiny camera on one end. The endoscope is guided via a small incision made in the patient’s wrist or palm. Using the same incision or the addition of another small one, cutting tools will be inserted. He will then cut the transverse carpal ligament, release pressure from the median nerve and then close the small incisions. The healing of this type of surgery is typically faster than an open carpal tunnel surgery, which debunks some common myths about carpal tunnel treatment and recovery.

How Effective is Carpal Tunnel Surgery?

There are over 400,000 carpal tunnel surgeries performed each year and the prognosis for usually very positive. Most people who have surgery for carpal tunnel syndrome report to have complete relief from their symptoms. They also have less or no pain and numbness in their hand, as well as better hand function after surgery. A few things also determine the effectiveness of surgery. The surgeon’s experience is one factor. Dr. Fitzmaurice performs this surgery more than anyone else in the country. Also earlier surgery results in a better outcome than letting the nerve compression become severe. At the Fitzmaurice Hand Institute, they also utilize nutritional techniques to enhance the healing. While, it can take several weeks or months for severe symptoms to disappear. The pain, however, usually improves rapidly after treatment.

Are There Risks?

For the most part, carpal tunnel release surgery is very safe. Bruising and temporary numbness in the hand can be experienced, but will go away after approximately 2-3 weeks.

Contact a Hand Surgery Expert Today

If you’d like to learn more about carpal tunnel syndrome and its treatment options, contact The Fitzmaurice Hand Institute and schedule an appointment with us.


Fitzmaurice Hand Institute
8841 E Bell Rd #201
Scottsdale, AZ 85260