Table of ContentsView AllTable of ContentsIncision vs. Pillar PainNumbness and TinglingInfectionNerve InjuryRecurrent CTS
Table of ContentsView All
View All
Table of Contents
Incision vs. Pillar Pain
Numbness and Tingling
Infection
Nerve Injury
Recurrent CTS
Surgery is acommon treatmentforcarpal tunnel syndrome, a condition that occurs when the median nerve, which travels from the forearm to the palm of the hand, becomes pressed or squeezed.Surgery can either be traditional open surgery orendoscopic minimally invasive surgery.
There are possible complications from this surgery, including what’s known as pillar pain. Pillar pain occurs on the sides of the surgical incision in the palm. It is also possible to experience numbness and tingling, nerve problems, and incision pain after surgery.
While the chance of experiencing complications is small, patients should understand these possible risks. This article will cover some of the common complications of both types of carpal tunnel surgery.
Incision Pain and Pillar Pain
Two types of pain may occur in the palm after carpal tunnel surgery: incisional pain and pillar pain.Pain around theincision siteis more common after traditional open surgery than endoscopic carpal tunnel release.
Pillar pain occurs to the sides of the incision in the thicker parts of the palm, called thethenarandhypothenareminence.This is where the transverse ligament attaches to the carpal bones (forming the carpal tunnel). The muscles of the palm are also located here.
Pillar pain is the more common and troublesome complication of carpal tunnel surgery and may take several months to resolve.
Treatments for pillar pain may include rest, massage, and hand therapy.
Persistent Numbness and Tingling
BURGER / PHANIE / Getty Images
There are two reasons why people may feelnumbness and tinglingafter carpal tunnel surgery. One is that the carpal ligament is not completely released.This can lead to persistent compression on the median nerve and, therefore, persistent symptoms.This complication is more common with endoscopic carpal tunnel surgery.
The second reason is nerve damage from long-standing compression to the median nerve. Some people who have had carpal tunnel syndrome for a long time may have persistent numbness and tingling even after surgery.Sometimes nerve damage is so severe that sensation is never restored to normal.
A nerve test called anelectromyography (EMG) studycan help indicate the severity of nerve compression before surgery.
bojan fatur / Getty Images
Infection is an uncommon complication but still possible after either open or endoscopic carpal tunnel surgery. It is important to follow your surgeon’s instructions carefully to ensure that you’retaking proper care of the incision area. There are steps you can take tohelp prevent the possibility of infection.
While some surgeons may prescribe antibiotics, they are not routinely needed for carpal tunnel surgery.If an infection does occur, antibiotics can be an effective treatment. Occasionally, additional surgery is needed to clean out the infection from the surgical wound.
Echo / Getty Images
Injury to the median nerve or its branches is uncommon during carpal tunnel surgery but it can happen.
The chance of a nerve injury is slightly higher with endoscopic carpal tunnel surgery but still very rare. In one study involving patients who underwent endoscopic carpal tunnel surgery, the median nerve was injured in only two of 694 (0.29%) hands.
If this injury happens, it typically affects a small branch of the nerve that either controls the thumb muscles (the motor branch) or the sensation of the palm (the palmar cutaneous branch).Symptoms can include pain, numbness, and weakness.
Often, an injury to the nerve is treatable. If the nerve injury is not too severe, the nerve may be able to heal itself, usually within about three months. Physical therapy with methods likeelectric stimulationcan be useful in keeping the surrounding muscles strong while the nerve heals.
If a nerve injury is severe or fails to heal on its own, it may be surgically repaired. The surgical procedure needs to be done as soon as possible and no more than six months after the initial surgery that caused the damage.
Though permanent nerve damage is rare, research has shown an increased risk of permanent damage if the revision surgery is delayed more than six months. This is because a severe nerve injury can lead to the progressive death of nerve cells if the nerve is not repaired promptly.
Recurrent Carpal Tunnel Syndrome
Marcela Barsse / Getty Images
It is possible to have recurrent symptoms after carpal tunnel surgery. This happens about 10% to 15% of the time.
This problem may be addressed with another surgical procedure. But the second surgery may be even less effective than the initial surgery.
Summary
Carpal tunnel surgery is very safe and effective in treating carpal tunnel syndrome. However, as with any invasive treatment, there are risks to this procedure. Some of these include numbness and tingling, pillar pain, infection, and nerve injury. Even though these complications are rare, patients should understand the possible risks of this treatment.
15 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Institute of Neurological Disorders and Stroke.Carpal tunnel syndrome fact sheet.American Academy of Orthopaedic Surgeons.Carpal tunnel syndromeChen Y, Ji W, Li T, Cong X, Chen Z.The mini-incision technique for carpal tunnel release using nasal instruments in Chinese patients.Medicine (Baltimore). 2017;96(31):e7677. doi:+10.1097/MD.0000000000007677Morán-Morán J, Mérida-Velasco JR, Del Valle EB, Murillo-González J.A mini-incision carpal tunnel release technique to prevent pillar pain: a technical note.Acta Orthop Traumatol Turc. 2021;55(1):73-75. doi:10.5152/j.aott.2021.20086Roh YH, Koh YD, Kim JO, Lee KH, Gong HS, Baek GH.Preoperative pain sensitization is associated with postoperative pillar pain after open carpal tunnel release.Clin Orthop Relat Res. 2018;476(4):734–740. doi:10.1007/s11999.0000000000000096Jones NF, Ahn HC, Eo S.Revision surgery for persistent and recurrent carpal tunnel syndrome and for failed carpal tunnel release.Plast Reconstr Surg. 2012;129(3):683–692. doi:10.1097/PRS.0b013e3182402c37Louie D, Earp B, Blazar P.Long-term outcomes of carpal tunnel release: a critical review of the literature.Hand (N Y). 2012;7(3):242-6. doi:10.1007/s11552-012-9429-xMorrell NT, Harris A, Skjong C, Akelman E.Carpal tunnel release: do we understand the biomechanical consequences?[published correction appears in J Wrist Surg. 2016;5(2):167].J Wrist Surg. 2014;3(4):235–238. doi:10.1055/s-0034-1394363Harvard Health Publishing.Don’t delay treatment for carpal tunnel syndrome.Hayden D, Bush C, Trevino R.Piloting a randomized, double-blind, placebo-controlled study design at a community hospital to evaluate prophylactic antibiotics in endoscopic carpal tunnel release: clinical, logistic, and economic considerations.Orthoplastic Surgery. 2021;6:7-10. doi:10.1016/j.orthop.2021.08.004Eroğlu A, Sarı E, Topuz AK, Şimşek H, Pusat S.Recurrent carpal tunnel syndrome: evaluation and treatment of the possible causes.World J Clin Cases. 2018;6(10):365-372. doi:10.12998/wjcc.v6.i10.365Wu F, Ng CY.The palmar cutaneous branch mimicking the recurrent motor branch of the median nerve.J Hand Microsurg. 2018;10(1):52-53. doi:10.1055/s-0037-1618330American Society for Surgery of the Hand.Nerve injury.Antoniadis G, Kretschmer T, Pedro MT, König RW, Heinen CP, Richter HP.Iatrogenic nerve injuries: prevalence, diagnosis and treatment.Dtsch Arztebl Int. 2014;111(16):273-279. doi:10.3238/arztebl.2014.0273Zieske L, Ebersole GC, Davidge K, Fox I, Mackinnon SE.Revision carpal tunnel surgery: a 10-year review of intraoperative findings and outcomes.J Hand Surg Am. 2013;38(8):1530–1539. doi:10.1016/j.jhsa.2013.04.024
15 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Institute of Neurological Disorders and Stroke.Carpal tunnel syndrome fact sheet.American Academy of Orthopaedic Surgeons.Carpal tunnel syndromeChen Y, Ji W, Li T, Cong X, Chen Z.The mini-incision technique for carpal tunnel release using nasal instruments in Chinese patients.Medicine (Baltimore). 2017;96(31):e7677. doi:+10.1097/MD.0000000000007677Morán-Morán J, Mérida-Velasco JR, Del Valle EB, Murillo-González J.A mini-incision carpal tunnel release technique to prevent pillar pain: a technical note.Acta Orthop Traumatol Turc. 2021;55(1):73-75. doi:10.5152/j.aott.2021.20086Roh YH, Koh YD, Kim JO, Lee KH, Gong HS, Baek GH.Preoperative pain sensitization is associated with postoperative pillar pain after open carpal tunnel release.Clin Orthop Relat Res. 2018;476(4):734–740. doi:10.1007/s11999.0000000000000096Jones NF, Ahn HC, Eo S.Revision surgery for persistent and recurrent carpal tunnel syndrome and for failed carpal tunnel release.Plast Reconstr Surg. 2012;129(3):683–692. doi:10.1097/PRS.0b013e3182402c37Louie D, Earp B, Blazar P.Long-term outcomes of carpal tunnel release: a critical review of the literature.Hand (N Y). 2012;7(3):242-6. doi:10.1007/s11552-012-9429-xMorrell NT, Harris A, Skjong C, Akelman E.Carpal tunnel release: do we understand the biomechanical consequences?[published correction appears in J Wrist Surg. 2016;5(2):167].J Wrist Surg. 2014;3(4):235–238. doi:10.1055/s-0034-1394363Harvard Health Publishing.Don’t delay treatment for carpal tunnel syndrome.Hayden D, Bush C, Trevino R.Piloting a randomized, double-blind, placebo-controlled study design at a community hospital to evaluate prophylactic antibiotics in endoscopic carpal tunnel release: clinical, logistic, and economic considerations.Orthoplastic Surgery. 2021;6:7-10. doi:10.1016/j.orthop.2021.08.004Eroğlu A, Sarı E, Topuz AK, Şimşek H, Pusat S.Recurrent carpal tunnel syndrome: evaluation and treatment of the possible causes.World J Clin Cases. 2018;6(10):365-372. doi:10.12998/wjcc.v6.i10.365Wu F, Ng CY.The palmar cutaneous branch mimicking the recurrent motor branch of the median nerve.J Hand Microsurg. 2018;10(1):52-53. doi:10.1055/s-0037-1618330American Society for Surgery of the Hand.Nerve injury.Antoniadis G, Kretschmer T, Pedro MT, König RW, Heinen CP, Richter HP.Iatrogenic nerve injuries: prevalence, diagnosis and treatment.Dtsch Arztebl Int. 2014;111(16):273-279. doi:10.3238/arztebl.2014.0273Zieske L, Ebersole GC, Davidge K, Fox I, Mackinnon SE.Revision carpal tunnel surgery: a 10-year review of intraoperative findings and outcomes.J Hand Surg Am. 2013;38(8):1530–1539. doi:10.1016/j.jhsa.2013.04.024
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
National Institute of Neurological Disorders and Stroke.Carpal tunnel syndrome fact sheet.American Academy of Orthopaedic Surgeons.Carpal tunnel syndromeChen Y, Ji W, Li T, Cong X, Chen Z.The mini-incision technique for carpal tunnel release using nasal instruments in Chinese patients.Medicine (Baltimore). 2017;96(31):e7677. doi:+10.1097/MD.0000000000007677Morán-Morán J, Mérida-Velasco JR, Del Valle EB, Murillo-González J.A mini-incision carpal tunnel release technique to prevent pillar pain: a technical note.Acta Orthop Traumatol Turc. 2021;55(1):73-75. doi:10.5152/j.aott.2021.20086Roh YH, Koh YD, Kim JO, Lee KH, Gong HS, Baek GH.Preoperative pain sensitization is associated with postoperative pillar pain after open carpal tunnel release.Clin Orthop Relat Res. 2018;476(4):734–740. doi:10.1007/s11999.0000000000000096Jones NF, Ahn HC, Eo S.Revision surgery for persistent and recurrent carpal tunnel syndrome and for failed carpal tunnel release.Plast Reconstr Surg. 2012;129(3):683–692. doi:10.1097/PRS.0b013e3182402c37Louie D, Earp B, Blazar P.Long-term outcomes of carpal tunnel release: a critical review of the literature.Hand (N Y). 2012;7(3):242-6. doi:10.1007/s11552-012-9429-xMorrell NT, Harris A, Skjong C, Akelman E.Carpal tunnel release: do we understand the biomechanical consequences?[published correction appears in J Wrist Surg. 2016;5(2):167].J Wrist Surg. 2014;3(4):235–238. doi:10.1055/s-0034-1394363Harvard Health Publishing.Don’t delay treatment for carpal tunnel syndrome.Hayden D, Bush C, Trevino R.Piloting a randomized, double-blind, placebo-controlled study design at a community hospital to evaluate prophylactic antibiotics in endoscopic carpal tunnel release: clinical, logistic, and economic considerations.Orthoplastic Surgery. 2021;6:7-10. doi:10.1016/j.orthop.2021.08.004Eroğlu A, Sarı E, Topuz AK, Şimşek H, Pusat S.Recurrent carpal tunnel syndrome: evaluation and treatment of the possible causes.World J Clin Cases. 2018;6(10):365-372. doi:10.12998/wjcc.v6.i10.365Wu F, Ng CY.The palmar cutaneous branch mimicking the recurrent motor branch of the median nerve.J Hand Microsurg. 2018;10(1):52-53. doi:10.1055/s-0037-1618330American Society for Surgery of the Hand.Nerve injury.Antoniadis G, Kretschmer T, Pedro MT, König RW, Heinen CP, Richter HP.Iatrogenic nerve injuries: prevalence, diagnosis and treatment.Dtsch Arztebl Int. 2014;111(16):273-279. doi:10.3238/arztebl.2014.0273Zieske L, Ebersole GC, Davidge K, Fox I, Mackinnon SE.Revision carpal tunnel surgery: a 10-year review of intraoperative findings and outcomes.J Hand Surg Am. 2013;38(8):1530–1539. doi:10.1016/j.jhsa.2013.04.024
National Institute of Neurological Disorders and Stroke.Carpal tunnel syndrome fact sheet.
American Academy of Orthopaedic Surgeons.Carpal tunnel syndrome
Chen Y, Ji W, Li T, Cong X, Chen Z.The mini-incision technique for carpal tunnel release using nasal instruments in Chinese patients.Medicine (Baltimore). 2017;96(31):e7677. doi:+10.1097/MD.0000000000007677
Morán-Morán J, Mérida-Velasco JR, Del Valle EB, Murillo-González J.A mini-incision carpal tunnel release technique to prevent pillar pain: a technical note.Acta Orthop Traumatol Turc. 2021;55(1):73-75. doi:10.5152/j.aott.2021.20086
Roh YH, Koh YD, Kim JO, Lee KH, Gong HS, Baek GH.Preoperative pain sensitization is associated with postoperative pillar pain after open carpal tunnel release.Clin Orthop Relat Res. 2018;476(4):734–740. doi:10.1007/s11999.0000000000000096
Jones NF, Ahn HC, Eo S.Revision surgery for persistent and recurrent carpal tunnel syndrome and for failed carpal tunnel release.Plast Reconstr Surg. 2012;129(3):683–692. doi:10.1097/PRS.0b013e3182402c37
Louie D, Earp B, Blazar P.Long-term outcomes of carpal tunnel release: a critical review of the literature.Hand (N Y). 2012;7(3):242-6. doi:10.1007/s11552-012-9429-x
Morrell NT, Harris A, Skjong C, Akelman E.Carpal tunnel release: do we understand the biomechanical consequences?[published correction appears in J Wrist Surg. 2016;5(2):167].J Wrist Surg. 2014;3(4):235–238. doi:10.1055/s-0034-1394363
Harvard Health Publishing.Don’t delay treatment for carpal tunnel syndrome.
Hayden D, Bush C, Trevino R.Piloting a randomized, double-blind, placebo-controlled study design at a community hospital to evaluate prophylactic antibiotics in endoscopic carpal tunnel release: clinical, logistic, and economic considerations.Orthoplastic Surgery. 2021;6:7-10. doi:10.1016/j.orthop.2021.08.004
Eroğlu A, Sarı E, Topuz AK, Şimşek H, Pusat S.Recurrent carpal tunnel syndrome: evaluation and treatment of the possible causes.World J Clin Cases. 2018;6(10):365-372. doi:10.12998/wjcc.v6.i10.365
Wu F, Ng CY.The palmar cutaneous branch mimicking the recurrent motor branch of the median nerve.J Hand Microsurg. 2018;10(1):52-53. doi:10.1055/s-0037-1618330
American Society for Surgery of the Hand.Nerve injury.
Antoniadis G, Kretschmer T, Pedro MT, König RW, Heinen CP, Richter HP.Iatrogenic nerve injuries: prevalence, diagnosis and treatment.Dtsch Arztebl Int. 2014;111(16):273-279. doi:10.3238/arztebl.2014.0273
Zieske L, Ebersole GC, Davidge K, Fox I, Mackinnon SE.Revision carpal tunnel surgery: a 10-year review of intraoperative findings and outcomes.J Hand Surg Am. 2013;38(8):1530–1539. doi:10.1016/j.jhsa.2013.04.024
Meet Our Medical Expert Board
Share Feedback
Was this page helpful?Thanks for your feedback!What is your feedback?OtherHelpfulReport an ErrorSubmit
Was this page helpful?
Thanks for your feedback!
What is your feedback?OtherHelpfulReport an ErrorSubmit
What is your feedback?
