The shooting or stabbing pain after your carpal tunnel surgery is normal and could be a byproduct of the procedure. Though it is expected, sometimes, when the pain intensifies after 2-3 weeks and feels much worse than before, it could mean another medical intervention. But, mainly, your pain can be lessened by getting enough rest, taking pain medicines, elevating your wrist or hand above heart level, limiting repetitive hand movements, and avoiding lifting objects. Managing your pain may optimize your recovery, and you might be able to bounce back to your daily activities after 3-6 months.
Before you undergo any surgical procedures, it is custom for doctors to let you know about their benefits and possible risks. Like any other illness, your doctor will only require surgery for carpal tunnel syndrome if your condition doesn’t improve after receiving other non-surgical treatments. Surgery is also necessary when you’re already at a high risk of nerve damage due to prolonged pressure.
Below are the benefits and risks of getting carpal tunnel surgery.
Benefits of carpal tunnel surgery
Carpal tunnel surgery has about a 90% success rate, and symptoms like tingling sensation on the hands or pain that wakes patients up in the night primarily diminish. But, only about 50% of those patients find complete relief after their surgery.
After their surgery, some reported shooting or stabbing pain, numbness, and pins and needles. These symptoms typically last for 3 up to 12 months.
Your recovery may depend on the severity of your post-surgical pain. Other factors that play an essential role in your overall recovery include the following:
1. The type of surgery
If you had the traditional open surgery, it might take a while to recover. But, it’s a safer method than an endoscopic surgery that may be a faster operation and requires lesser recovery time but has a higher risk of nerve injury.
2. The type of anesthesia
Wide-awake local anesthesia may offer you faster recovery time with lower potential risks than general anesthesia.
3. Your age
Older people may have slower recovery because their body, in general, is already slowing down.
4. Pre-existing health conditions
These include arthritis or tendonitis and diabetes mellitus.
5. The severity of nerve compression
Long-standing or prolonged nerve compression may result in significant nerve damage which, could be hard to treat or have low chances of complete healing.
6. Ability to follow post-surgical care guidelines
Strictly following doctors’ advice and prescriptions may optimize healing progress.
Risks of carpal tunnel surgery
When looking for a lifetime relief through surgery, you may want to talk to your doctor about the potential risks of getting the procedure. Both open and endoscopic surgery will give you similar results.
Remember that each has its drawback, and there are potential risks that you may have to face.
Below are some of the complications you may experience after getting carpal tunnel surgery. One of these could be the reason for your shooting or stabbing pain.
1. Infection
Signs of infection include fever accompanied by intense pain, swelling, bleeding, and draining of pus at the incision site.
Please inform your doctor immediately if you notice redness and warmth or changes of color on your wrist or palm and streaks of blood leak through your bandages. It could indicate that the stitches may have gotten loose, and your wound is at risk of infection.
You may need to take antibiotics when an infection is causing your pain. It’s important to follow your doctor’s guidelines on how to take care of your incisional wound, like keeping your bandages clean and dry.
If the infection becomes worse, another surgery is required.
2. Nerve injury
Although injury to the median nerve or its branches is uncommon, it is certainly a risk for hand surgery patients.
The risk is specifically higher for patients who had endoscopic carpal tunnel surgery. A typical site of injury occurs in the small branches of the median nerve that controls the muscles of the (motor branch) or the branch that carries sensation from or to the palm (the palmar cutaneous branch).
3. Recurrent carpal tunnel syndrome or failed surgery
This happens to about 10-15% of people who had carpal tunnel surgery, which means their symptoms may diminish but go back again (recurrent) after a few weeks or months.
If you still experience the symptoms of your carpal tunnel syndrome after surgery, your doctor may consider this a failed surgery. Often, you might need a second carpal tunnel release surgery, also known as revision surgery which, results may not be as promising and only has about 10-59% success rate.
Patients with a failed carpal tunnel surgery may have to live or cope with the recurring symptoms, which may take a few years to improve or, in worse cases, last permanently.
4. Other complications
These may include a sensitive scar, bleeding, and injury to nearby or surrounding blood vessels or tissues of the transverse carpal ligament.
Stabbing pain and numbness after carpal tunnel surgery
Post-surgical pain and other discomforts are usually expected regardless of the type of surgery you had. While doctors don’t know its exact cause, pain could be due to the procedure itself or other things.
These could include the hyperstimulation of your nervous system due to damaged nerves during the surgery (postoperative neuropathic pain), chronic inflammation, or the formation of scar tissue on your surgical site.
It’s important to distinguish between the two types of pain following carpal tunnel surgery from pain caused by other postoperative complications.
If chronic pain occurs or symptoms are much worse than before you had the surgery, it may indicate other problems such as infection, nerve injury, and failed surgery.
Incisional pain
This describes the sudden or shooting pain directly on the area of your wrist or palm where your doctor took a cut (incision). It commonly occurs in patients who had open surgery and typically happens right after or in the early stages of your recovery. The pain would generally last for several days or weeks.
Below are things you can do to lessen your incisional pain:
- Take pain medicines as prescribed by your doctor. If you weren’t given prescriptions, ask your doctor for it. You better ask permission before buying an over-the-counter pain medicine to be safe.
- Avoid lifting objects or gripping activities early after surgery. It may take you several weeks to gradually return to these activities when your wound has completely healed.
- Limit forceful hand movements. After your surgery, your doctor may only recommend you to do simple and easy hand or finger movements to avoid stiffness.
- Elevate your hand above heart level. Do this procedure as much as possible to keep your blood circulating.
Pillar pain
This type of pain is the trickiest to deal with between the two. It occurs on the sides of the incision site or the thicker, fleshy sides of the cut.
This is where your transverse carpal ligament (the tissue your surgeon cut) is attached to your carpal (wrist) bones. During surgery, your muscles at this site might have been disturbed, contributing to the pain you’re feeling.
Depending on the intensity of your pillar pain, it may take 2-6 months before it goes away. If the pain becomes excessive, it might be a sign of complications.
Take note that you may not notice any changes or improvement from this type of pain which will test your patience. By strictly following your doctor’s guidelines, you should be able to see differences between weeks of your recovery.
Things you can do to lessen pillar pain include:
- Get enough rest
- Keep your hand or wrist rested above heart level when sitting or lying down.
- Gently massage wrist
- Do hand or physical therapy
Tingling and numbness
In cases that you experience tingling and numbness in your thumb or your first three fingers, there could be two reasons why this might happen:
- Your transverse carpal ligament wasn’t entirely cut. It means that there is still pressure acting on the median nerve due to the persistent compression of the tissues. This often occurs in patients who have had endoscopic surgery.
- There is significant nerve damage due to long-standing compression on the median nerve. Thus, it’ll be impossible to restore your hand health when severe nerve damage occurs. Sometimes, other tissues may have been compressing on the nerve such that cutting the transverse carpal ligament won’t resolve the issue. This could also cause severe nerve damage leading to persistent tingling and numbness of your hand.
Ways to manage pain and numbness after carpal tunnel surgery
Pain, numbness, and weakness should go away in a few days or several months following a successful carpal tunnel surgery. Your doctor will let your wear a splint for about 2 weeks after removing the large bandage.
When your wound has finally healed, your doctor will remove the stitches. You might feel worse than before, but you should gradually start having your strength back in about 3-4 months, or like in some people, it could take you up to a year.
Usually, it would take 6-10 weeks before you can go back to work if you had open surgery on your dominant hand, and your job requires a lot of repeated and heavy action (e.g., laborer, custodial, or rescue services).
If your work only requires a light manual (e.g., managerial or clerical) and you had surgery, on the other hand, you may be able to go back to work after 7-14 days.
Make sure to follow your doctor’s guidelines on how to take care of yourself at home after your surgery. It will help you manage any post-surgical pain and optimize your recovery.
Tips to take care of yourself and reduce pain at home
- Get enough rest
- Do simple exercises like walking every day to improve blood circulation
- Avoid doing repeated arm of hand movements. This includes typing or using a computer mouse, washing dishes, cleaning windows, vacuuming, or chopping food. Avoid activities that cause vibration, such as using power tools
- Limit carrying weights for up to two weeks after your surgery. You may do heavier tasks in about 4 weeks of your recovery.
- Only take a bath when your incision has completely healed or when your doctor says it’s ok.
- Do not drive until you can fully use both hands.
- Eat normally or try bland and low-fat food when you get an upset stomach. This includes plain rice, broiled chicken, toast, and yogurt.
- Wait for your doctor’s instruction about restarting your medications or taking new prescriptions.
- Take pain medicines as prescribed. You can also buy over-the-counter pain relievers such as acetaminophen (Tylenol), ibuprofen (Advil, Motrin), or naproxen (Aleve). Do not take two drugs simultaneously unless your doctors say so.
- Take an entire course of antibiotics (if prescribed). Do not stop taking until you finish the prescription.
- Keep the bandage clean and dry. Wrap a plastic cover when taking a bath or change it when it gets wet or dirty.
- Do wrist and hand exercises. You will have to work with your doctor and physiotherapist to guide you throughout the rehabilitation program.
- Put ice compress or cold pack over your wrist for 10 to 20 mins every 1-2 hours interval until the swelling goes down.
- Keep your wrist or hand elevated above heart level when sitting or lying down.
- Go to all follow-up appointments with your doctor and tell them everything about your recovery.
When to call your doctor
Call your doctor immediately if you feel excessive pain that doesn’t seem to go away after the first 2-3 weeks of your surgery.
When symptoms listed below occur, please let your doctor know immediately.
- Fever
- Redness, swelling, bleeding, or pus draining from the incisio
- Increased pain on the incision
- Signs of loose stitches or the incision comes open
- Tingling, weakness, or numbness of your hands or fingers that became much worse than before surgery
- Changes of color in your wrist or hands
- Splint, cast, or bandages are loose or too tight
- Symptoms become worse
Takeaway
Pain, tingling, and numbness are usually expected after carpal tunnel surgery and could be part of your recovery. But, it could also signal for another medical intervention if symptoms are much worse before surgery or you’re not getting better as expected.
If you feel increased pain, have a fever, or show signs of infection such as swelling and bleeding, you should call your doctor immediately. They might require another test to examine for complications from your surgery or another condition causing your persistent pain.
