Carpal tunnel syndrome occurs as a result of structure degeneration or inflammatory swelling in the carpal tunnel. Due to the swelling, the delicate median nerve is compressed and degenerates. The resulting pressure may cause pain and interfere with daily activities.

The decision to perform surgery is made by a physician during the orthopedic consult. The doctor takes the patient’s history to determine the symptoms and the situations in which they appear or worsen. Then, the specialist performs a physical examination with palpation and an ultrasound to visualize the changes inside the wrist. If the doctor believes that the patient’s symptoms are related to the median nerve, they will refer the patient for electromyography (EMG). This test involves the measurement of nerve conduction impulses to determine whether the compression of the median nerve is located in the carpal tunnel or at another level.

The patient reports to the facility on an empty stomach and with recent blood test results. The doctor prepares the surgical field and administers local anesthesia before the procedure. The surgery for carpal tunnel syndrome involves making an incision in the skin on the palmar side of the wrist in the area of the flexor retinaculum and dissecting the tissues until the retinaculum is visible. The retinaculum is cut or (much less frequently) a Z-cut is made, which allows the retinaculum to be lengthened without cutting through it. The procedure takes up to 30 minutes and the patient can leave the facility immediately after the procedure.