Driving after carpal tunnel operation

When we have undergone surgery for carpal tunnel syndrome, the length of time before we can get back to our usual activities will vary from person to person. In general, you will need to wait until you have had all your stitches removed; usually 10-14 days after your operation. You may need to wait longer if you do not feel that full strength has returned to your wrist; it can take up to a month to be able to return to all of your normal activities (NHS, 2021). Before you return to driving, you must be confident that you are able to manage this task safely, and perform all necessary manoeuvres using your hand, including an emergency stop if required. As full recovery times may vary for individuals, if you are concerned it would be best to speak with your GP or surgeon for confirmation on when it is safe for you to return to driving.

What is carpal tunnel syndrome?

Carpal tunnel syndrome is the name for a group of symptoms that are experienced when we experience compression of the medial nerve, which runs through the carpel tunnel in the wrist. The carpal tunnel is area in the wrist between the carpel bones and the ligament; along with the medial nerve, tendons also run through here (Patient UK, 2021).

Symptoms of carpal tunnel syndrome

The medial nerve is the nerve that gives feeling to the thumb, index and middle fingers and to half of the ring finger and controls the small muscles at the base of the thumb (Patient UK, 2021). As these are the areas that are controlled by the medial nerve, it makes sense that it is in these areas that we feel the symptoms of carpal tunnel syndrome.

The most common symptoms we experience with carpal tunnel syndrome are:

• A weakness in the thumb, or difficulty gripping
• Numbness in the hands and finger
• Tingling or pins and needles
• Skin changes to the affected hand such as dry skin
• Pain or aching in your fingers, hand or arm (NHS, 2021).

To start with you will likely experience these symptoms intermittently, often when moving or using the hand and as the condition worsens this feeling may become more persistent. Many people find that their symptoms appear worse at night time (Patient UK, 2021).

Causes of carpal tunnel syndrome

As above, carpal tunnel syndrome occurs when pressure is put on the medial nerve in the wrist. We may not always be able to identify an underlying cause of carpal tunnel syndrome but there are some things that can make you more at risk of developing this condition (NHS, 2021):

• Genetic factors and family history - there appears to be a genetic link that may make you more prone to developing carpal tunnel syndrome
• Being overweight
• Being pregnant
• Medical conditions including arthritis, diabetes and hypothyroidism (Patient UK, 2021)
• Previous wrist injury
• Frequently carrying out repetitive tasks that involve bending your wrist, particularly if this involves vibration going through the wrist
• Cysts, growths or swelling developing in the wrist.

This is not an exhaustive list of all the possible underlying factors that could make you more at risk of developing this condition, but it gives you an idea of some of the more common things.

Diagnosing carpal tunnel syndrome

Your GP can usually diagnose carpel tunnel syndrome from carrying out a physical examination, assessment of your symptoms and taking into account your medical and lifestyle history.

If your GP is unsure of your diagnosis you may be referred on to a specialist, or for further tests such as nerve conduction tests, ultrasound scan or an MRI scan (NICE, 2021). If you will potentially require surgical intervention you will also be referred on to a specialist for this. Blood tests are not usually indicated unless it is to identify whether there are any contributing underlying conditions, such as diabetes or hypothyroidism (NHS, 2021).

Treatments for carpal tunnel syndrome

What treatment you will need will depend on the severity of your symptoms; generally, the least invasive treatment(s) will be tried first.

Sometimes explicit treatment may not be necessary; treatment may focus on removing the underlying cause, if there are any, for example, this could mean (NICE, 2021):

• Ensuring underlying conditions such as diabetes or hypothyroidism are well or better controlled
• Weight loss guidance if appropriate
• Trying to avoid the activities or repetitive movements that worsen the symptoms
• Use of painkillers if required
• Engaging in hand exercises; if this is required then you might want to speak with a pshyiotherapist.

If you are suffering with carpel tunnel syndrome due to pregnancy you will often notice that your symptoms resolve once the baby is born (Patient UK, 2021); if this does not happen however then you may need to look into alternative treatment options.

If your symptoms are particularly troublesome and you want to look into other possible treatment options, some options that may be available to you include:

Wrist splinting 

This is often advised as a first line treatment. Wrist splints can be brought over the counter and you can ask your local pharmacist for guidance on which one would be most appropriate for your condition. You will hopefully see some relief of from your symptoms if used for at least 4 weeks, and could cure the condition (NHS, 2021; Patient UK, 2021).

Steroid injections

Your GP may suggest trying a steroid injection if wrist splinting has not been effective. Here a steroid is injected into the wrist in the aim to help reduce inflammation of the nerve, reducing the symptoms of carpal tunnel syndrome. Unfortunately, steroid injections do not always cure carpal tunnel syndrome and you may require repeat injections in the future (NHS, 2021).

Surgery

If other treatment methods have not been effective, then you may be referred to discuss whether surgical interventions would be necessary. This procedure is carried out under local anaesthetic, and takes around 20 minutes, which means that you will usually not need to stay in hospital overnight. During the surgery a small cut will be made on your wrist and into the carpel tunnel, so that it no longer puts pressure onto the nerve (NHS, 2021).

Surgery will usually cure carpel tunnel syndrome, however as with any surgical procedure, there are risks of complications, including infection and nerve damage, and recovery can take some time (NHS, 2021; Patient UK, 2021). You will also likely be left with a small scar on your wrist.

Your specialist will discuss all of the risks of this procedure with you and help you to weigh up to risks and the benefits to decide whether this procedure is right for you.

You will likely not be able to use your hand or wrist for a couple of weeks after the operation, and it can take up to a month before you can get back to all of your usual activities. Exactly how long this will take is likely to vary from person to person and your specialist may well be able to give you more individualised guidance on your recovery times. 

Answered by the Health at Hand team.

Sources and further reading

Carpal tunnel syndrome - NHS factsheet

Boost your bone power! - AXA Health

Muscles, bones and joints - AXA Health hub

References

NHS, 2021. Carpal tunnel syndrome. Available at: Carpal tunnel syndrome - NHS (www.nhs.uk). (Accessed 16 March 2021)

NICE, 2021. Carpal tunnel syndrome. Available at: Carpal tunnel syndrome | Health topics A to Z | CKS | NICE. (Accessed 17 March 2021).

Patient UK, 2021. Carpal tunnel syndrome. Available at: Carpal Tunnel Syndrome | Symptoms and Treatment | Patient (Accessed 17 March 2021).