Advice after your nerve block for surgery
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Carpal Tunnel Syndrome
It is a condition where the median nerve gets compressed in the carpal tunnel of the wrist. The ‘carpal tunnel’ lies in the wrist, as you can see from the picture below. The tunnel is made up of the transverse carpal ligament and carpal bones. Through this tunnel runs the median nerve and tendons that bend your fingers
Symptoms of Carpal Tunnel Syndrome
The median nerve provides feeling to the palm side of your hand, thumb, and your index, middle and part of your ring fingers. This nerve controls some of the muscles which move the thumb. It also carries information back to the brain about feelings in your thumb, index, middle and part of the ring fingers. Because of this, when the nerve becomes compressed, it produces pins and needles and numbness in the hands. Many people also report waking at night with numbness or pain. This happens due to the natural position people tend to sleep in, with their hands curled inwards, reducing space in the carpal tunnel. Depending on how severe the compression is, you may also experience stiffness, weakness or clumsiness in your hands.
Carpal Tunnel Decompression
Surgery aims to relieve the pressure on the median nerve and allows the nerve to send and receive the correct signals to the brain once again.
The surgeon makes one or two cuts to the transverse ligament, which then changes the shape of the carpal tunnel to a more circular one. This allows the median nerve a greater amount of space and reduces the pressure on it.
You will normally be discharged home the same day and your hand will be dressed and bandaged for at least one week after the surgery.
After the Surgery
You can move your hand gently as pain allows and use your hand for light activities.
Pain relief
You may need pain relief following your surgery. For most patients, simple paracetamol (available over-the-counter) is usually sufficient. Sometimes, you may be discharged with a prescription for Co-codamol, which contains a combination of paracetamol and codeine. The usual dose is two tablets, up to four times a day. Do not take additional paracetamol if you are already taking Co-codamol, as it already contains paracetamol.
Activities of Daily Living
It usually takes about two weeks before you can use your hand normally, so you may need some help at home, especially if it’s your dominant hand. During this time, avoid lifting anything heavy, gripping tightly, pulling, or pushing with the affected arm until the wound has healed.
Driving
You cannot drive while wearing a bulky bandage. Once dressings are reduced, you may drive when you have full movement, feel comfortable, are in full control of the vehicle and can safely perform an emergency stop. Pain or weakness may prevent safe driving for 1–2 weeks. It is your responsibility to ensure you are fit to drive, as this may affect your insurance. You should always check with your insurance company if your policy is valid before you drive.
Recovery
Most patients find relief from their symptoms soon after surgery but recovery can continue for up to 6 months; especially if you had symptoms for several months before your surgery. Strength can take the longest to recover. Sometimes, full recovery is not possible, this is usually when the nerve damage was severe before your surgery.
Swelling
Your hand and fingers may be swollen after your surgery. It is important to get your swelling down as quickly as possible. To do this you should elevate your hand above your heart as much as possible.
- Reach your arm in the air or above your head regularly during the day
- Rest your hand on your shoulder
- Rest your hand on cushions
Scar Management
Scars can become raised, thick/stuck and a deep red/purple colour. They can be uncomfortable, painful or sensitive to touch and stop you moving your fingers and wrist easily.
24 hours after your stitches are out you should begin to massage your scar. If you have dissolvable stitches you can start to massage ten days after your surgery. Massage will help the scar to become soft, flat, more pale and give the scar more movement as well as reducing the pain and sensitivity.
Your scar may take up to two years to fully mature. Massage for the first few months after surgery will make the biggest difference to your scar.
Use a thick unscented cream like E45, Nivea, Aqueous or similar.
Massage needs to be firm and deep, not like putting on hand cream. Support your hand and massage firmly/with pressure in circles across the scar.
Pillar Pain
It is common to experience pain and discomfort around the heel of your hand because the surgery cuts the connecting tissue between the muscles. To relieve this, you can massage the muscle bulks, see the below image. This will also help your scar if you find it is too sensitive to touch directly in the early stages after your surgery.
Exercises
Your hand may have reduced grip strength and may become stiff following surgery. Perform the following exercises to make sure your wrist and fingers don’t get stiff following surgery. Repeat all the exercises 2-3 times per day.
Exercises are very important to stop the fingers getting stiff, to help reduce the swelling, and to prevent the scar getting stuck. You may feel uncomfortable or tight feelings when you are doing the exercises, but they should not be painful.
Resting up on your elbow
- First make a fist
- From there straighten your fingers
- Then stretch your wrist backwards
- Then stretch your thumb out to the side
- Then turn your arm around so you are looking at your palm.
- Then, if it is not painful, gently pull down on your thumb to increase the stretch feeling.
Two weeks after your surgery, you can start the final exercise:
If your hands aches for more than 30 minutes after your exercises you should try to do less next time.
Contact details
Ensure to reach out to a healthcare professional or directly to your surgical team with any pre or post operative concerns.
Hand therapy departments:
0300 6133396 for Frimley
0300 6140540 then Option 2 Wexham or Option 3 for Heatherwood
Plastic Dressing Clinic - 0300 6153031
Contact us
If you have any queries relating to this information, please contact the Hand therapy service.
About this information
Service:
Hand therapy
Reference:
UU/013
Approval date:
1 November 2025
Review date:
1 November 2028
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Important note
This page provides general information only. It is developed by clinical staff and is reviewed regularly every 3 years for accuracy. For personal advice about your health, or if you have any concerns, please speak to your doctor.