Carpal Tunnel Release

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What is Carpal Tunnel Release?

Carpal tunnel release is a surgery performed to treat carpal tunnel syndrome.

In carpal tunnel syndrome, the median nerve becomes compressed or squeezed as it passes through the carpal tunnel en route to the hand. The carpal tunnel is a space formed by bones and ligaments in the wrist. When there is not enough room in the carpal tunnel for the nerve to travel without being compressed, the nerve will become damaged and carpal tunnel syndrome will develop.  

A common misconception is carpal tunnel syndrome occurs only in people who do a lot of repetitive activities with their hands, like typing. While repetitive activities can contribute, carpal tunnel syndrome is a very common issue and can be the result of arthritis, wrist fractures, genetics, obesity, diabetes, and even your gender.  

When a carpal tunnel release surgery is performed, the ligament forming the roof of the carpal tunnel is cut to relieve pressure on the median nerve. Once the pressure on the nerve is removed, the nerve can begin to heal, and the painful numbness & tingling symptoms of carpal tunnel syndrome can begin to improve & hopefully resolve altogether.

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Who May Need a Carpal Tunnel Release?

Common Symptoms of Carpal Tunnel Syndrome:

  • Hand numbness & tingling
  • Pain in the fingers, palm, wrist  
  • Loss of dexterity in the hand (e.g. difficulty buttoning shirts, picking up small objects, etc.) 
  • Weakness in grip
  • More

Assessing for Carpal Tunnel Syndrome

At KCOA, you will meet with skilled orthopedic specialists to ask you questions about your symptoms & to perform a thorough physical exam. 

Common questions you may be asked at your initial appointment include:

  • What symptoms do you have—Pain? Numbness? Tingling?  
  • Where do your symptoms occur—Certain fingers? The whole hand? Any spread of symptoms into the forearm or arm? 
  • Are your symptoms constant or do they come and go with certain activities or times of day? 
  • Do your symptoms limit your ability to function?—With daily activities? At work? With certain hobbies? 
  • What are your goals for treatment? 

Workup

In addition to a detailed history & examination, advanced testing is often required for a complete diagnosis. This may include: 

Electrodiagnostic Testing: Electromyogram (EMG) & Nerve Conduction Studies 

Electrodiagnostic testing measures the function of a person’s nerve. It identifies the presence of nerve damage, the location of nerve damage, and the severity of nerve damage. Specifically in carpal tunnel syndrome, electrodiagnostic testing helps verify the presence & severity of carpal tunnel syndrome, evaluates for other issues in the hand that resemble carpal tunnel syndrome, and can identify if other nerve injuries are present that may influence the course of carpal tunnel syndrome. The test is performed in clinic by our board-certified physiatrists. The EMG (electromyogram) portion involves a small pin being inserted into a muscle to measure how the muscle is receiving nerve messages—it looks similar to acupuncture. The NCS (nerve conduction study) portion involves a light pulse being sent across the nerve to measure the health of the nerve—it feels like a TENS unit.  

Diagnostic Ultrasound 

Diagnostic Ultrasound evaluates the structure of a person’s nerve. Specifically in carpal tunnel syndrome, it can confirm the presence of carpal tunnel syndrome, evaluate for nearby masses or structural abnormalities that may be contributing to the carpal tunnel syndrome, and identify anatomical variations that may affect management. The test is performed in clinic by our board-certified physiatrists with training in diagnostic ultrasound. The ultrasound is a pain free test performed on you while you are laying down with your arm & wrist extended. 

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Establishing a Care Plan

Based on your history, exam, and advanced testing, your KCOA orthopedic provider will discuss with you the best management options for your specific circumstance. Treatment may include conservative options such as using a wrist brace at night, hand therapy, or injections.

If a person has incomplete benefit with more conservative management or has moderate to severe nerve damage on testing, a carpal tunnel release is the most reliable & definitive management for carpal tunnel syndrome. 

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How It Works

Carpal tunnel release is a minimally invasive surgery. It is performed as an outpatient procedure, which means the person returns home the same day.

There are three ways a carpal tunnel release can be performed: an open carpal tunnel release, an endoscopic carpal tunnel release, or carpal tunnel release with ultrasound guidance. 

 

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Pre-Op

Pre-operative instructions will vary depending on your physician and location of your surgery. Always check with your physician before surgery for their specific instructions. 

 Surgeries performed at a hospital or surgericenter and may require that a patient not eat or drink after midnight prior to surgery. Surgeries performed in the clinic do not have those requirements.  

You will need a family member or friend to drive you home the day of the surgery.  

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Day of Surgery

Regardless of where you are having the procedure done, once you are checked in for the procedure your physician will visit with you to review the procedure, answer any questions you have, and go over a consent form.  

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Post-op

You will be able to move your hand and fingers immediately after the procedure. In general you can use the hand for activities of daily living (dressing, eating, grooming) immediately after the procedure. Each patient’s recovery plan and timeline for healing differs based on several factors. A person’s age, activity level, current health, severity of the carpal tunnel syndrome, and goals for recovery will all play a role in the healing process.  

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Post-op (cont.)

It’s important to take care of your body to ensure optimal results following your procedure. Rest, ice, and elevation can help during the healing process. If you are a smoker, you may be asked to refrain from smoking in the weeks before and after the procedure as smoking will delay healing. 

Once the incision is healed, hand therapy may be recommended to strengthen the hand and improve range of motion. 

Managing Carpal Tunnel Syndrome

Carpal Tunnel Release Procedures

Open carpal tunnel release

Open carpal tunnel release is performed at a hospital or a surgericenter. It involves making a small incision large enough to allow the surgeon to see the carpal tunnel. Once completed, your surgeon will stitch up the area and place your hand and wrist in a splint or securing bandage. 

Endoscopic release

Endoscopic release surgery is performed at a hospital or a surgericenter. It involves making one or two small incisions. A thin, flexible tube that contains a camera is put into the wrist to help guide the surgeon to cut the ligament. Once completed, your surgeon will stitch up the area and place your hand in a securing bandage. The stitches are often buried, and absorb with time, thus may not warrant a separate appointment for removal. 

Carpal tunnel release with ultrasound guidance

Carpal tunnel release with ultrasound guidance is performed in the clinic under sterile conditions. It involves making a small incision at the wrist through which a device is guided into the carpal tunnel to cut the ligament under direct ultrasound visualization. Once completed, the incision is glued shut and bandaged, stitches are generally not required. 

Why KCOA for Carpal Tunnel Syndrome?

KCOA is the most comprehensive hand center in the Kansas City area. In addition to having experts in all the techniques a carpal tunnel release surgery can be performed, we are experts in the non-operative conservative management options for carpal tunnel syndrome. Non-surgical treatments for carpal tunnel syndrome may include: 

Hand Therapy

A trained therapist will focus on the issue that’s causing the pain or symptoms as well as the deficits that are present as a result of the injury. Stretches, strengthening exercises, manual soft tissue work, and other modalities may help you recover.

Bracing

your physician may prescribe a brace to help maintain your wrist in neutral position to reduce irritation. With carpal tunnel syndrome, using a brace at night can improve night time worsening of symptoms.

Injections

Injections can reduce inflammation and improve a person’s symptoms for a period of time. Steroid injections, also referred to as cortisone injections, are the most common type of injection performed. Other types of injections can be helpful as well, such as dextrose injections and platelet rich plasma (PRP) injections.

F.A.Q.

Frequently Asked Questions

Kansas City Orthopedic Alliance is here to help.

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With access to board-certified specialists across Kansas City, we have the tools to meet almost every musculoskeletal condition.

Use our Symptom Tracker Tool to connect with the right KCOA physician for your unique needs—and get back to the things that matter most.

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Our Locations

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Overland Park, Kansas

10777 Nall Ave Suite 300 Overland Park, KS 66211

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3651 College Blvd. Leawood, KS 66211

Kansas City, Missouri

Saint Luke's Medical Plaza #1 4320 Wornall Rd., Ste. 610 Kansas City, MO 64111

Belton, Missouri

Belton Regional Campus 17067 S Outer Rd #301 Belton, MO 64012

Blue Springs, Missouri

St. Mary’s Medical Center, Main Entrance 203 NW R.D. Mize Road, Suite 250 Blue Springs, MO 64014

Shawnee Mission, Kansas

7450 Kessler St ste. 140 Merriam, KS 66204

Prairie Star (Lenexa, Kansas)

Prairie Star 23401 Prairie Star Pkwy
Bldg. B, Ste. 220 Lenexa, KS 66227

Testimonials

Very professional

Very professional physician and staff.
Janet Frieden

Professional

The first thing that I noticed was the traffic flow. This may sound strange but people were being seen and sent out on their way. There was not a huge roomful of frustrated, tired patients. If most (I assume) had uncomfortable and or painful maladies, they didn’t have to wait forever for attention. That was how it was for me. Professional and personable patient care.

Jillian Merrill

Great people

Great people who are very willing to help you work through the best way to handle your injury.

Kathy Martinez

Very knowledgeable

6 weeks post op and Dr. Brown says I’m progressing well. She’s very knowledgeable, and is very quick to answer any questions I have. She’s also very personable, we laughed a lot during my last appointment. Looking forward to seeing her again.

Kayla Mora

Very pleased

My experience with Dr. Moore, at Apex Sports Medicine has been very positive. She is very competent and confident in her abilities. She is very thorough in explaining things and answers any and all questions. I am very pleased.

Kristy Clemmons