Carpal Tunnel Surgery Pain
Is There Much Pain with Carpal Tunnel Surgery?
Following your carpal tunnel surgery, pain can be expected. But it's a different kind of pain compared to that caused by carpal tunnel syndrome.
As the anesthesia wears off after surgery, the pain may be a little more intense than other surgical procedures. It usually feels worse because the concentration of pain is in a smaller area (your hand). In addition, your hand and palm have lots of nerve endings, making them the most sensitive body parts.
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All surgery results in pain. And the degree of pain depends on the type of surgery you have. Generally, there is more pain as more (and different kinds of) tissues are disrupted. And the hand has many different types of tissues packed in a small area. Skin, tendons, muscles, bones, and ligaments are all disrupted during carpal tunnel surgery.
This is why carpal tunnel surgery pain is usually considered to be moderate to severe in the short term. The post-surgical pain usually lasts a few days and then slowly dissipates.
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However, complications and other factors can extend the pain much further. That means some degree of pain can last for weeks or months. In rarer cases, pain can drop to a lower level but never go away completely. Of course, any of this can increase your carpal tunnel surgery recovery time to some extent.
Surgery pain usually comes from two sources. They are
incisional pain and
pillar pain,
which are discussed below.
Incisional carpal tunnel surgery pain
This type of pain comes from the actual cut skin and tissues below it. In carpal tunnel surgery, disruption of a lot of different tissue layers occurs. So cutting through all of these layers is what produces the pain. It’s the same type of sharp, stinging pain you get if you cut your finger with a knife. But a knife usually only cuts skin.
Incisional pain typically only lasts a few days to a couple weeks at most. Keeping the wound clean and avoiding lifting or gripping things helps lessen the pain. Also, keeping your hand elevated as much as possible reduces swelling and subsequent pain.
Incisional pain is greater with open carpal tunnel release surgery. That’s because the cut is 2-3 inches long on the palm. Compare that to a half inch cut made with endoscopic carpal tunnel release surgery. The incisional pain is much less.
Pillar carpal tunnel surgery pain
Pillar pain is different. This is pain from the sides of the cut, on the two bumps in your lower palm. The pain most often occurs with the open release technique. It is much less common with endoscopic carpal tunnel surgery.
Actually, pillar pain occurs when a branch of the median nerve is damaged. That branch runs to the skin on the palm.
Pillar pain is also the most often reported carpal tunnel surgery pain. It is also the most difficult type of pain to treat.
Other pain
• Infection pain
One complication of carpal tunnel surgery is infection. The infection may be on the surface. But if it has reached down into the wrist, it’s much more serious. The doctor will take immediate action to keep the infection from spreading.
First, the doctor will order antibiotics. If the infection is severe, the doctor performs another surgery to clean out the infection. Afterwards, a drainage tube may be required for a few days. All of these add to the normal carpal tunnel surgery pain you already have.
• Doctor-induced pain
If there is a complication during surgery, the result can be additional pain. A good example is if the doctor damages one or more blood vessels in the wrist. That’s just more disrupted type of tissue to produce pain. And it adds to the normal pain after this operation.
• Persistent pain
Finally, if the surgery was not successful, pain may persist or recur. This is considered a failed surgery. There are few options left for the patient at this point.
Only
10-60% of patients
with second (“revision”) surgeries have relief of symptoms if the first surgery failed. The remainder go on to live with the persistent pain and manage it as best they can.
Conclusion
All patients experience carpal tunnel surgery pain to some degree. This pain typically lasts for a few days and gradually declines. But if pain persists, or if it extends out from the incision area, then it could be the sign of another problem. Contact your doctor if this occurs.