Carpal Tunnel Surgery
ہاتھ کی دبی ہوئی نس کا آپریشنCarpal tunnel surgery frees the median nerve where it is squeezed at the wrist, the cause of hand numbness and tingling. This small operation is performed by Dr. Salman Falak, consultant neurosurgeon in Lahore, under local anaesthesia as a day case. Its aim is to stop the night numbness and protect the hand's strength before the damage becomes permanent.
What carpal tunnel syndrome is and who needs surgery
The carpal tunnel is a narrow passage on the palm side of the wrist, with the wrist bones as its floor and a tough ligament as its roof. The median nerve runs through it together with the tendons that bend the fingers. When the tunnel becomes too tight, from swelling of the tendons, fluid retention, thyroid disease, diabetes, pregnancy or years of repetitive hand work, the nerve is squeezed. The result is carpal tunnel syndrome: numbness and tingling in the thumb and the fingers next to it, often worst at night and on waking, so that patients shake the hand to get relief. Later come aching in the wrist and forearm and weakness of the thumb muscles, so that things slip from the hand and the muscle at the base of the thumb can visibly waste. Women are affected more often than men, and it is common in the middle years of life. Both hands are often involved, one worse than the other.
Surgery is for patients whose symptoms persist despite splints and injections, and for those whose nerve test shows moderate or severe compression or who already have weakness or muscle wasting. Waiting too long at that stage risks damage that surgery cannot undo.
How Dr. Salman Falak performs carpal tunnel release
Carpal tunnel release is a short operation, usually done under local anaesthesia, so the patient is awake and the hand is numbed with an injection. The injection stings for a moment and then the hand feels heavy and numb. Some pressure is felt during the operation but no pain, and an anxious patient can be given light sedation as well. A small cut is made in the palm at the base of the wrist, in line with the ring finger. The ligament that forms the roof of the tunnel is divided, which gives the nerve room, and the skin is closed with a few stitches. Magnification helps the surgeon see the nerve and its small branches and protect them throughout. The patient goes home the same day with a light dressing. If both hands are affected, the other hand is usually done at a later date so that one hand stays free for daily tasks.
Benefits and realistic outcomes
The night numbness and tingling often improve within days of release, and sleep returns. Feeling in the fingertips and strength in the thumb recover more slowly, over weeks to months, because a squeezed nerve heals at its own pace. When the nerve has been badly compressed for a long time and the thumb muscles have wasted, surgery stops further damage and usually relieves the pain, but the lost strength and feeling may not come back fully. That is why a patient with constant numbness or a weak grip should not wait for the problem to pass on its own.
Who is a candidate, and when surgery is not the answer
Mild, recent symptoms are treated first without surgery. A wrist splint worn at night holds the wrist straight and relieves the night symptoms for many. A steroid injection into the tunnel settles swelling and can give months of relief, and it also tells the doctor whether the diagnosis is right. Treating an underlying cause, such as an underactive thyroid or uncontrolled diabetes, helps too. Symptoms in pregnancy usually settle after delivery and are managed with a splint.
Surgery is advised when these steps fail, and without delay when the nerve test shows severe compression or weakness or wasting has appeared. It is not advised when the numbness is coming from the neck instead of the wrist, which a careful examination and the nerve study can tell apart, or when the diagnosis is uncertain. Send a description of your symptoms and any nerve test report on WhatsApp, and Dr. Salman Falak will tell you whether release is the right step.
Before surgery: the nerve test and preparation
A nerve conduction study, sometimes with a needle test called EMG, is the main test. It measures how fast signals pass through the median nerve at the wrist and grades the compression from mild to severe, which guides whether to operate and how urgently. An ultrasound of the wrist or an X-ray is sometimes added, and a neck MRI if the pattern suggests the neck. Blood tests for thyroid and sugar look for a cause. Preparation is simple. Keep taking your usual medicines unless told otherwise, and tell the doctor about blood thinners. Come with someone who can take you home. Patients from other cities can often have the nerve study done locally and send the report on WhatsApp before the visit.
Recovery and using the hand afterwards
The hand can be used for light tasks, such as eating and dressing, from the first day, and moving the fingers early prevents stiffness. Keep the dressing dry and the hand raised when resting for the first few days to limit swelling. Stitches are removed at about two weeks. Heavy gripping and lifting are avoided for some weeks while the ligament heals, and some tenderness at the scar, called pillar pain, is common for a while and fades. Office work is usually possible within a week or two; manual work takes longer. Driving waits until the dressing is off and the hand grips the wheel comfortably. Patients from Gujranwala, Faisalabad, Sialkot or Phool Nagar can have the stitches removed locally and the follow-up done by video consultation, with a photo of the wound sent on WhatsApp.
Where the surgery is done
Dr. Salman Falak sees patients in Lahore at Sharif Medical City Hospital in Jati Umra on Raiwind Road, at Life Hospital in Bahria Town and at Doctor Care Hospital in Al Kabir Town, and the release is done as a day case in Lahore. Patients from Gujranwala can be seen first at his Friday OPD at Gujranwala Medical Complex on G.T. Road, and patients from the Phool Nagar area on Tuesday. A video consultation with the nerve test report sent ahead is a good first step for anyone who has to travel.
Risks, and why delay is the bigger risk
Carpal tunnel release is a low-risk operation, but not a zero-risk one. Possible problems are infection, a tender scar, temporary weakness of grip, injury to a small nerve branch that leaves a patch of numbness in the palm, and, uncommonly, an incomplete release with symptoms that persist. Recurrence after a proper release is unusual. These risks are reduced by magnification and careful technique, and by early finger movement with a clean dressing.
The bigger risk for most patients is waiting. A nerve that stays squeezed for years loses fibres, and the thumb muscles waste while the numbness becomes constant. At that point surgery still helps, but it cannot restore what has already been lost. If your fingers are numb all day or your grip has weakened, ask for an opinion now.
Related conditions and procedures
The condition itself is explained on the carpal tunnel syndrome page, which also covers how it differs from a pinched nerve in the neck. Numbness that runs down the whole arm with neck pain is more likely to come from the neck; see neck pain and cervical radiculopathy. All of Dr. Salman Falak's operations are listed on the services page.
Related procedures
Conditions this treats
Where it is done
Operations are performed in Lahore. Consultations are held in Lahore, at Gujranwala Medical Complex on Fridays and in Phool Nagar on Tuesdays, or by video for patients travelling from further away.
Questions patients ask
How much would carpal tunnel surgery cost?
The fee depends on the hospital, on whether one or both hands are done and on the type of anaesthesia, and it is explained at the consultation. Because the operation is a day case under local anaesthesia, there is no ward stay to add. Ask for the breakdown so that you can plan.
Which doctor is best for carpal tunnel surgery?
Carpal tunnel release is done by neurosurgeons and by hand surgeons from plastic or orthopaedic backgrounds. What matters is training in nerve surgery and regular practice with this operation, along with a clear explanation of when to operate and when to wait. Dr. Salman Falak is a consultant neurosurgeon with MS Neurosurgery training from Sir Ganga Ram Hospital, Lahore, and treats compressed nerves as part of his routine work.
What is stage 4 carpal tunnel?
There is no official stage 4. Doctors grade carpal tunnel syndrome on the nerve test from mild to severe, and people use stage 4 to mean the severe end: constant numbness and a weak thumb with visible wasting of the muscle at its base. At that stage surgery should not be delayed, because nerve damage becomes permanent.
How risky is carpal tunnel surgery?
It is one of the lower-risk operations in nerve surgery. It is done under local anaesthesia through a small cut, and most patients go home within a few hours. The possible problems are infection and a tender scar, and uncommonly injury to a small nerve branch or an incomplete release. Leaving a severely compressed nerve untreated is usually the greater risk.
Can I travel back to Faisalabad the same day?
Usually yes. The operation is a day case under local anaesthesia, so you can leave the hospital after a short period of observation, with someone else driving. Keep the hand raised on the journey. The stitches can be removed locally and the follow-up done by video.
Do I need a nerve conduction study before the consultation?
It helps, and if you already have one please bring it or send it on WhatsApp. If you do not, Dr. Salman Falak will examine you first and arrange the test if it is needed. Patients from other cities can often get it done nearby and send the report before travelling.
Can both hands be operated on together?
Both hands are often affected. Most surgeons prefer to do one hand at a time, usually the worse one first, so that the patient has one working hand while the other heals. The second hand is done a few weeks later once the first has recovered.
Send your MRI. Get a clear answer before you travel.
WhatsApp your reports and your city, and you will be told whether surgery is likely, which tests to bring, and which OPD is nearest to you.