Driving after carpal tunnel operation

You shouldn't usually drive your car until your stitches are removed, which is usually about 10-14 days after surgery.

This is because you need to have enough strength and control in your hand to be able to control the car safely and make an emergency stop, should you need to. If you do not feel confident about handling your car safely, then you should delay driving until the strength in your wrist returns.

Do check with your surgeon about their expectations for your recovery after carpal tunnel syndrome surgery as each case varies.

Causes of carpal tunnel syndrome

Carpal tunnel syndrome (CTS) is a condition that occurs when the median nerve, which controls feeling and movement in your hand, is put under pressure in your wrist.

It’s not known what causes this to happen, but the following people may be more at risk:

• Family history of CTS
• Pregnancy (many cases sort themselves out after the birth)
• Menopause
• Repetitive motion (particularly if it involves a lot of bending, gripping or vibrations going through the wrist
• Injury to your wrist
• Certain health issues, such as obesity, an underactive thyroid or diabetes.

Carpal tunnel symptoms

CTS usually starts with pain, discomfort or tingling in the thumb and first three fingers, usually at night or early in the morning. In some people, however, the hand and forearm can be affected differently.

It can develop gradually and affect both hands eventually.

In some cases there are other symptoms, such as:

• Aching that can spread to the hand and up the arm
• a burning or prickly feeling in your hand
• skin changes in the hand – it can become dry, change colour or swell
• loss of sensitivity
• Weakness – this can often happen in the thumb.

Carpal tunnel testing and diagnosis

If your symptoms of CTS persist, you should visit your GP.

Your doctor will examine your hand, wrist and arm, and ask about your symptoms. As part of this your doctor might tap or flex your wrist, or ask you to hold it above your head for a minute.

This is usually enough to diagnose CTS, but your doctor may pursue further tests to check the extent of the damage, or if they are concerned about underlying causes. For example,

• they may carry out blood test to rule out diabetes.
• a nerve conduction test, to measure how quickly your nerve sends signals, could be used to see how much your median nerve is damaged.
• an ultrasound scan might be performed so doctors can take a look at your nerve.

Carpal tunnel treatment

Carpal tunnel treatment depends on how much your nerve is damaged, how bad your symptoms are and how you would like to be treated.

The first thing to do is work out what actions make your symptoms worse and avoid them. Some cases of CTS get better by themselves. For example, if you are pregnant and get CTS, this usually clears up around 6-12 weeks after birth (if it does not you will require treatment).

If your CTS is caused by another condition, such as diabetes, treating the underlying cause should relieve your CTS.

Wrist splints are usually the first port of call for treating CTS. Splints can be bought over the counter, and you should notice an improvement within 4 weeks of wearing the support.

If the splint doesn’t work you could have a steroid injection into the wrist. If you respond well to the first one, you could try another.

Surgery – known as carpal tunnel decompression or carpal tunnel release surgery – is the next option. This is where doctors cut the carpal ligament to relieve pressure on the nerve.

Some surgeons use specialist equipment and do the procedure as through keyhole means, others will make an open incision in the wrist.

This is usually done under local anaesthetic and you won’t need to stay in hospital overnight.

Surgery usually cures CTS but, as always, there is a risk that you could suffer complications – such as scarring or nerve damage – and recovery can take a while.

You usually have to keep your hand raised and in a bandage for 2 days after the operation. You may also have to wear a sling.

Within a day or two you should be able to start doing light exercises with your hand, elbow and shoulder to avoid getting too stiff.

You can start with gentle activities too, but should avoid anything too strenuous until you have fully recovered, which can take a few weeks.

Answered by the Health at Hand team.

Sources and further reading

Carpal tunnel syndrome - NHS factsheet

Boost your bone power! - AXA Health