When a nerve in the hand is affected, your ability to move your hands and perform even simple routine tasks, such as picking up objects, may be impaired. One common cause is excessive pressure on the nerves, leading to compression. Hand nerve release surgery aims to relieve this pressure and restore hand function. (1)

What is hand nerve release surgery?

Hand nerve release surgery relieves pressure on a specific nerve in the hand or wrist. It is usually considered after other treatments, such as splints or injections, fail to relieve pain or symptoms.

The procedure may involve: (2)

  • Expanding the space around the nerve to give it more room.
  • Removing anything pressing on the nerve.

Results of the surgery

Unlike alternative treatments, hand nerve release surgery addresses the root cause, helping to: (3)

  • Reduce chronic pain.
  • Restore sensation in the hand.
  • Improve hand mobility and ability to perform daily activities.
  • Reduce reliance on painkillers.
  • Prevent further nerve damage.
  • Improve overall quality of life.

Indications for surgery

Hand nerve release surgery is intended to relieve pressure on a nerve in the hand or wrist and treat symptoms like pain, numbness, and weakness. Nerve compression usually occurs due to overuse or certain medical conditions. Common cases include: (4)

  1. Carpal tunnel syndrome – the most common, caused by compression of the median nerve as it passes through the wrist, leading to pain and numbness in the thumb and fingers.
  2. Cubital tunnel syndrome – caused by compression of the ulnar nerve at the elbow, leading to numbness in the ring and little fingers.
  3. Pronator syndrome – a rarer condition where the median nerve is compressed near the elbow, causing forearm pain and hand numbness.
  4. Injuries – such as fractures or sprains that damage the nerves.


Surgery is usually considered for patients who:

  • Have persistent symptoms for at least 3 months.
  • Do not improve with conservative treatments like physical therapy, medications, or splints.

A thorough evaluation, including nerve conduction tests, helps determine the need for surgery.

Preparing for surgery

Preparation may include: (4)

  • Certain medical tests to assess your condition.
  • Specific instructions regarding fasting, medications, and the timing of the procedure.

How is the surgery performed?

Hand nerve release surgery typically takes about one hour and generally involves: (4)

  1. Making small incisions at the site of nerve compression.
  2. Using specialized surgical tools to locate the compressed nerve, expose it, and release it from surrounding tissues.
  3. Closing the incision.
  4. Applying a dressing, and sometimes a splint to protect the area.

Recovery after surgery

Following your doctor’s instructions helps ensure a smooth recovery: (4)

1. Immediate post-surgery care

  • Pain: Some discomfort is expected and can be managed with prescribed painkillers.
  • Swelling: Elevate the hand or arm for 24 hours after surgery.
  • Wound care: Keep the incision clean and dry.

2. Rest and immobilization

  • A splint or brace may be used temporarily.
  • Avoid strenuous activities, heavy lifting, or strong gripping initially.

3. Physical therapy

  • Gentle stretching and movement exercises may be recommended.
  • Focuses on simple hand motions to prevent stiffness and aid recovery.
  • Gradually return to daily activities; full function often returns in weeks to months.

4. Nerve healing

  • Sensation improves, and numbness and weakness gradually resolve for most patients.
  • In some cases, nerves may not fully recover if damage was severe before surgery. (5)



References

  1. Florida Orthopaedic Institute - Hand nerve decompression
  2. Thames Shoulder & Elbow - Nerve decompression Surgery
  3. Physio.co.uk - Nerve Decompression
  4. The Center for Hand and Upper Extremity Surgery - Nerve Decompression Surgery
  5. Milton Keynes University Hospital - Carpal Tunnel Decompression