Carpal tunnel surgery


Do 30 min


Lokalna anestezija


Dnevna bolnišnična


Up to 30 minutes


Local anesthesia


Day hospital


4 - 6 weeks


In 14 days


6 weeks (depending on the nature of the work)

The carpal tunnel is an anatomical passage on the underside of the wrist through which the median nerve passes. This nerve allows sensation and movement of the hand and fingers. When the median nerve is under pressure or severely irritated, carpal tunnel syndrome can occur. This common condition affects many people, especially those who perform precise and repetitive hand and finger movements in their work.

Proper treatment can eliminate tingling and numbness and restore normal wrist and hand function.

What are the causes of carpal tunnel syndrome?

Carpal tunnel syndrome most often occurs due to pressure on the median nerve that passes through the carpal tunnel - when we put a lot of strain on the wrist for a long time and repeatedly.

The carpal tunnel consists of the carpal bones on the back of the hand and a rigid connective tissue plate on the palm side (transverse carpal ligament). The median nerve and finger flexor tendons are located in the canal, which enable the fingers to bend and thus grasp and perform other fine movements. The carpal tunnel has the greatest volume when the wrist is in a neutral position. The volume of the canal decreases when the wrist is bent forward or backward, which can cause excessive pressure.

The main causes of pressure on the median nerve are:

- Repetitive hand movements: Work that requires repetitive hand movements, such as typing on a keyboard or using a mouse, increases the risk of carpal tunnel syndrome. Such movements can irritate the nerve and cause inflammation of the tendons in the carpal tunnel.

- Arthritis: Joint inflammation from arthritis can cause swelling of tissues near the carpal tunnel, which compresses the median nerve.

- Hormonal Changes: Hormonal changes during pregnancy or menopause can lead to fluid retention in the tissues, putting pressure on the median nerve. The same can happen in men.

- Injuries and fractures: Injuries to the wrist or fractures near the carpal tunnel can cause swelling that compresses the nerve. After recovery, the problem sometimes resolves itself, but sometimes the nerve remains pinched.

- Other diseases: A tumor (ganglion) may appear in this part of the hand, which presses on the carpal tunnel and the nerve. .

- Hereditary tendency: Some people have a genetic tendency to have a narrower carpal tunnel, which increases the chance of developing carpal tunnel syndrome.

Carpal tunnel syndrome can occur in one or both hands, often starting in one hand and later affecting the other. This is especially common among manual workers, factory workers, and office workers who use both hands throughout the day.

Risk factors

There are certain risk factors that make it more likely that you will develop carpal tunnel. These include:

- female sex, as women are more likely to have a pinched nerve because their carpal tunnel is anatomically narrower;
- a close relative , who developed the same condition;
- job where you do repetitive lifting;
- fracture near the wrist;
- chronic conditions that affect the nerves, e.g. diabetes;
- inflammatory conditions such as arthritis, which can cause swelling of the joints;
- conditions where you retain too much water in your body, e.g. pregnancy or kidney problems;
- obesity, due to increased pressure on the joint.

"Carpal tunnel syndrome most often occurs due to pressure on the median nerve that passes through the carpal tunnel - when we put a lot of strain on the wrist for a long time and repeatedly."

What are the first symptoms?

The symptoms of carpal tunnel syndrome usually develop gradually, which can make the diagnosis process difficult and long. The most common symptoms are as follows:

- Numbness and tingling: They appear in the thumb, index finger, middle finger and part of the ring finger, most often at night. When sleeping, people often sleep with their wrists clenched, which further increases the pressure on the nerve.

- Pain: Pain in the wrist, palm, and hand occurs as the syndrome progresses and may spread. also towards the elbow.

- Poor grip and reduced mobility: Pressure on the nerve weakens the muscles in the hand, which affects the strength of grasping and lifting objects.

- Problems with fine movements: Precise movements such as tying shoelaces or buttoning buttons become more difficult and less precise.

Our patients often report waking up in the morning with numbness and tingling in arms reaching up to the shoulders.
Symptoms worsen during the day, especially during activities such as work, driving, or holding the phone where the wrist is bent.

In the initial phase, many people fix the problem by shaking hands. As the disease progresses, however, the numbness does not go away with exercise or shaking.

As the muscles in the hand contract, everyday activities become very uncomfortable. Pain and muscle spasms increase as the central nerve in the hand does not work properly.

How does the doctor's examination work?

If you notice any of the above symptoms, it is important to consult a doctor as soon as possible. The diagnosis of carpal tunnel syndrome requires a detailed examination and discussion with a doctor. During the examination, we will obtain all the necessary information about your symptoms and possible risks. We will take a detailed medical history, ask you about your symptoms, the duration of your problems, and any risk factors that could contribute to carpal tunnel syndrome. Be sure to bring the results of the EMG (electromyography) examination to the examination.

Then we will perform a clinical examination, which usually includes:

- Physical examination of the wrist: Check for possible swelling, pain or tenderness.
- Tinel's sign test: Gently feel your finger over the carpal tunnel to check for tingling or numbness in the fingers. A positive Tinel sign may indicate nerve compression in this area.
- Phalen sign test: During this test, you will be asked to bend your wrist down and keep your palm in a vertical position. If tingling or pain occurs within one minute, the test is positive and indicates the possibility of carpal tunnel syndrome.
- Electromyography (EMG): In some cases, we may also recommend an EMG, which measures the electrical muscle activity and nerve function. This can be useful to confirm the diagnosis and assess the severity of nerve damage.
- Wrist imaging: This includes ultrasound, magnetic resonance imaging (MRI) and X-ray imaging (X-ray). Ultrasound allows visualization of the internal structure of the wrist, similar to magnetic resonance imaging and X-rays.

If the examination and possible tests confirm the diagnosis, we will provide you with detailed information on various treatment options, including surgery.

If now you are noticing the initial symptoms, you can adjust your lifestyle yourself. We recommend as much movement and gentle stretching of the arms as possible, reducing repetitive movements (as much as possible) and wearing a brace while sleeping. Before sports and other activities where you use your hands intensively (work, housework, long drives...), warm them up properly.

Where can I have an inspection?

If you suspect of carpal tunnel syndrome, do not hesitate and contact us. At Fabjan Clinics, we are committed to providing the highest level of care in the treatment of this and other wrist problems. We have a trained team of specialists who will examine your symptoms and advise you on the best treatment options.

When are we suitable for carpal tunnel surgery?

Carpal tunnel surgery is recommended when conservative treatment methods, such as reducing activity, using splints or anti-inflammatory drugs, do not provide sufficient symptom relief. Some signs that surgery may be necessary include:

Progression of symptoms or failure of non-operative treatment
: If, despite conservative treatment, you notice a worsening of symptoms, such as more severe pain, numbness, or impaired mobility, surgery is a reasonable option to improve the condition.

Limited hand function
: Carpal tunnel syndrome can severely limit your ability to perform daily tasks and work. If it affects your productivity or quality of life, it's really worth considering surgery.

Demonstrated nerve damage
: Electromyography (EMG) can confirm the presence of median nerve damage.

It is important not to delay seeing a doctor. Untreated carpal tunnel syndrome can cause long-term and worsening symptoms. If the condition is diagnosed in time, the treatment is much easier and makes it possible to prevent permanent damage to the muscles and to restore the normal function of the hand. Longer delay brings a higher risk of complications and incomplete treatment.

How is carpal tunnel surgery performed?

Carpal tunnel surgery is safe and effective if it is performed by a properly trained and experienced surgeon.

Before the operation, we will thoroughly examine your health and discuss any allergies, medications and other details, which are important for the safety of the intervention. Carpal tunnel surgery can be performed under local anesthesia, which means that you will be awake during the procedure, but you will not feel pain. In some cases, we may also use general anesthesia to ensure your comfort during the procedure. We will discuss the appropriate anesthesia at the consultation.

The course of the operation

The goal of carpal tunnel surgery is to reduce pressure on the median nerve, which is achieved by cutting the ligament that compresses it.

Carpal tunnel surgery is an outpatient procedure, which means you can return home the same day. It takes about 20 to 30 minutes, depending on the complexity of the case. During the operation, we make a small incision in the palm or wrist to access the carpal tunnel.

Before the operation
: Before the procedure, we will inform you in detail about the procedure, the expected results, possible risks and complications, and obtain your consent to the operation. We will also advise you on how to prepare for surgery, including stopping food and drink before the procedure.

: You will receive a local anesthetic to numb the area around your wrist, which will prevent pain during surgery. If we decide on general anesthesia during the consultation, you will be asleep during the procedure.

Making the incision
: We will make a small incision in the palm or wrist to reach the carpal tunnel. This incision is usually only a few centimeters long and is almost invisible after surgery.

Carpal Tunnel Widening
: In the next step, we will widen the carpal tunnel to reduce pressure on the median nerve. This is achieved by removing part of the tissue surrounding the canal or by cutting the transverse ligament. Both methods are medically approved and we have extensive experience with them.

Closure of the cut
: After the surgery is completed, we will sew the cut with stitches.

Wraping and dressing:
Immediately after the operation, the operated area will be wrapped for protection.

Recovery after the procedure

After the operation, you will be kept under observation for a while to make sure there are no complications. Once we confirm that your condition is stable, we will discharge you home. In most cases, this happens the same day, as hospital recovery is not necessary and you will feel better at home. You will receive detailed instructions for recovery and our special phone number for direct contact. It is important not to drive yourself home, as anesthesia can still cause drowsiness or dizziness.

In the first days after the procedure, you can start moving your fingers, but only up to the limit of pain. ; after three days you can perform the exercises more intensively. The skin (visible) stitches will be removed after 14 days, while the subcutaneous (invisible) stitches gradually break down by themselves and do not need to be removed. After 14 days, you can start massaging the scar longitudinally with an oily ointment or anti-scar cream.

In the first days after surgery, avoid using the operated arm and lifting heavy objects. After three weeks, most patients can perform light tasks. More difficult tasks are possible after about a month, and really difficult tasks after about two months. Decreased strength in the fingers, occasional tingling and painful scarring may last for several months and gradually resolve within a year.

Possible complications

Carpal tunnel surgery is usually safe, but as with any surgical procedure, there are certain potential complications. These are relatively rare in carpal tunnel surgery. Among them are:

- Infection at the site of the operation.
- Bleeding from the cut.
- The formation of larger scars.
- Problems with wound healing.

Sometimes inconveniences occur, such as numbness, tingling or pain for a longer recovery time.

Complications are best avoided if your procedure is performed by a specialist and if you properly follow the recovery instructions. If you have any concerns about the complications and consequences of the operation, we will discuss this in detail during the consultation. For the best recovery after the procedure, we advise you to follow the written instructions, exercise early and rest your arm, as you will feel pain, less strength and less mobility.

Informative price for carpal tunnel surgery

The price of the intervention depends on the specifics of each individual and is determined at the end of the consultation.

Basic Plan



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