Expert Carpal Tunnel Surgery in Toronto

Our skilled plastic surgeons perform carpal tunnel release surgery at our Canadian facilities, providing effective treatment for carpal tunnel syndrome in the hand and wrist.

Meet Our Surgeons

Carpal tunnel release surgeries are performed at St. Michael’s Hospital by four highly qualified Plastic Surgeons: Dr. Matthew McRae, Dr. Mark McRae, Dr. Blake Murphy, and Dr. Joseph Catapano.

Dr. Mark McRae

Surgeon

Dr. Matthew McRae

Surgeon

What is Carpal Tunnel Surgery, and Why You Need It?

Carpal tunnel syndrome can cause pain, numbness, and weakness in your hand and wrist. This happens when your median nerve, which controls sensation and movement in parts of your hand, becomes compressed as it passes through a narrow space in your wrist known as the carpal tunnel.

What is Carpal Tunnel Surgery?
Carpal tunnel surgery, or carpal tunnel release, is a procedure we perform to relieve this nerve pressure. During the surgery, your surgeon will make a small incision to release the ligament pressing on your median nerve. By creating more space within the carpal tunnel, we can ease nerve compression, reduce symptoms, and promote healing.

How Carpal Tunnel Surgery Can Help You
If other treatments haven’t provided lasting relief, carpal tunnel surgery may be the best next step. Here’s how we can help you:

Relief from Pain: By relieving pressure on the nerve, our surgery aims to reduce or eliminate pain, allowing you to feel comfortable again.
Restoration of Sensation: Many of our patients regain normal sensation, with numbness and tingling significantly reduced, so you can fully feel and use your hand.
Improved Hand Strength and Function: Surgery can restore your hand’s strength and grip, making daily tasks easier and more comfortable.

Who Is a Candidate for Carpal Tunnel Surgery?

If you’ve been dealing with persistent pain, numbness, or tingling in your hand and fingers, you might be wondering if carpal tunnel surgery is the right step. Generally, surgery is an option when other treatments haven’t provided the relief you need. Here are some situations where you might consider surgery:

When Other Treatments Haven’t Helped: You’ve tried treatments like physiotherapy, wrist splints, or medications, but they haven’t resolved the symptoms. Surgery can be the next step when these options haven’t been effective.
Long-Lasting Symptoms: If you’ve had ongoing pain or numbness for several months without improvement, it may be time to consider a more lasting solution. Surgery can help relieve the pressure on your nerve and give you back a pain-free range of motion.
Difficulty with Daily Activities: If carpal tunnel symptoms are making it hard to do everyday tasks—like gripping, typing, or holding objects—surgery can be an effective way to regain control and strength in your hand.
Loss of Sensation in Fingers: If you’ve started to lose feeling in your fingers, especially in the thumb, index, and middle fingers, this can indicate worsening nerve damage. Surgery can help prevent further damage and restore sensation.

Where Are Carpal Tunnel Incisions Made?

In carpal tunnel release surgery, the incision is typically made in the palm, near the base of the wrist. This location allows your surgeon to access the transverse carpal ligament, which is the ligament pressing on the median nerve and causing your symptoms.

The incision is usually between 2 and 5 cm but may be longer in very large hands. Your surgeon uses precise techniques to make the incision as discreet as possible while ensuring enough space to safely release the ligament and relieve the pressure on your nerve.

The Benefits of Carpal Tunnel Surgery

Relief of Symptoms: The primary benefit is the reduction or elimination of pain, numbness, and tingling in the hand and fingers. Most patients experience significant improvement in symptoms following the surgery.
Improved Hand Function: Many patients experience better hand strength and function, making it easier to perform daily activities like typing, writing, or gripping objects.
Prevention of Nerve Damage: If left untreated, carpal tunnel syndrome can lead to permanent nerve damage. Carpal tunnel release can prevent or reduce the risk of long-term complications like muscle weakness or atrophy in the hand.
High Success Rate: The procedure is generally very effective, with studies showing improvement in 80-90% of patients, especially if the symptoms are not too severe before the surgery.

Limitations of Carpal Tunnel Surgery

Incomplete Relief of Symptoms: Despite a high success rate, a percentage of patients (about 10-20%) do not experience complete relief of symptoms after the surgery. This can occur if the median nerve was already damaged before surgery or if other factors (such as cervical spine issues) are contributing to symptoms.
Post-Surgical Pain: Some patients may experience temporary discomfort, swelling, or stiffness after the surgery, which can take several weeks or months to fully resolve.
Nerve Damage: In rare cases, the procedure may lead to additional nerve damage or complications, such as nerve irritation or injury to the superficial palmar nerves.
Recurrence of Symptoms: In some cases, carpal tunnel syndrome can recur after surgery.
Recovery Time: While many patients experience improvement within a few weeks, full recovery takes 3 months or slightly longer for pain-free heavy activities. A subset of patients may need physical therapy or exercise to regain full hand strength and flexibility.

Who Should Get Carpal Tunnel Release Surgery?

Persistent Symptoms: Patients with moderate to severe symptoms (numbness, tingling, pain in the median nerve distribution) have not improved with conservative treatments for 3 months.
Nerve Conduction Studies: Electrodiagnostic studies indicate moderate to severe median nerve compression at the wrist.
Weakness: Notable weakness in hand grip or atrophy of the thenar muscles, indicating muscle involvement.
Failure of Conservative Treatment: Lack of improvement with non-surgical management options (e.g., splinting, corticosteroid injections, activity modification).
Diabetes or Other Comorbidities: Patients with conditions that predispose them to severe nerve compression may warrant earlier surgical intervention.
Patient Preference: When patients prefer surgical intervention after understanding the risks and benefits.
Acute Cases: In rare cases of acute carpal tunnel syndrome, such as from trauma or infection, surgery may be indicated urgently.

A special note is that people who smoke have a significantly higher risk of infection and stiffness after carpal tunnel release surgery. Every attempt should be made to quit smoking before surgery.

Requirements for Your Consultation

To book a consultation with us, we require a referral from a licensed family doctor or MD in Ontario. Additionally, a nerve conduction study confirming carpal tunnel syndrome is needed to provide an accurate diagnosis and the best care plan.

If you don’t have a referral, no problem! Consultations are available without one for a fee of $200. If a nerve conduction study hasn’t been done yet, we can arrange it for you, though this may slightly delay the procedure timeline.

How is Carpal Tunnel Release Surgery Performed?

Preparation and Anesthesia

A combination of lidocaine and Marcaine is injected into the wrist and palm to provide immediate anesthesia, ensuring the area is completely numb for the procedure. Numbness may last anywhere from 2 hours to 24 hours after the procedure.

Cleaning of the hand

The hand is thoroughly cleaned using chlorhexidine to eliminate bacteria and maintain a sterile environment for the surgery.

Incision

A 2-3 inch (5-7 cm) incision is made on the palm side of the wrist, slightly off-center. For larger hands, the incision may extend slightly onto the forearm.

Release of the Transverse Carpal Ligament

The transverse carpal ligament is carefully incised to relieve pressure on the median nerve, which is the critical step to alleviating carpal tunnel symptoms.

Inspection and Hemostasis

The surgeon inspects the median nerve for any signs of damage or constriction. Any bleeding vessels are cauterized or clipped to ensure a clean and safe surgical field.

Closure and Dressing

The incision is closed with absorbable stitches, which will naturally fall out within three weeks. If preferred, stitches can be removed during a follow-up appointment two weeks post-surgery. Finally, a dressing is applied to the wrist and palm for protection.

Aftercare and Recovery After Carpal Tunnel Release Surgery

Recovering from carpal tunnel release surgery involves several steps, each with specific timelines. Here’s a guide to what you can expect and how to care for your hand throughout each stage of recovery.

Local Anesthetic
The hand and fingers will remain numb for between 4 and 24 hours after the procedure.
Light activity with the hand
You may use your operated hand after surgery, but only for light activities. You cannot lift more than 10 lbs with the hand for 1 month after surgery.
Remove dressing at 1 week
You can remove the dressing at 1 week after surgery. You should then wash your hands with soap and water daily. Epsom salt soaks are also an option. The incision should not be exposed to pet fur or dirty water such as dishwater.
Antibacterial cream
You should apply polysporin or fucidin to the incision daily from day 8 to 14 after surgery. Do not use for more than 7 days.
Sutures
Sutures will fall out on their own. This usually happens at about 3 weeks after surgery. If it is your preference, sutures can be removed for you at a follow-up visit 2 or more weeks after surgery.
Massage
Gentle massage of the incision line should start 3 weeks after surgery. You can use any moisturizing lotion, but preferably one without any scent. This will help soften the area and smooth the skin.
Activity return
At one month after surgery, there are no limits to activity. You are allowed to lift anything, but keep in mind that heavy activity should be avoided for 3 months after surgery due to discomfort at the incision line.

McRae Plastic Surgery

Toronto Location:

Address: 30 Bond Street, Martin Family Center, B1 (Ground Level), Donnelly Wing

Toronto, ON M5B 1W8

Office Phone Hours for General Patient Inquiries:

Monday-Friday: 7:30 am – 3:30 pm
Phone: 416-360-4000 ext. 5830

Cosmetic Surgery Phone Hours for Toronto Location:

Monday-Thursday: 12:30 pm – 4:30 pm
Friday: 8:00 am – 4:30 pm
Phone: 416-638-3499