Your doctor's instructions for carpal tunnel surgery aftercare will include a checklist of signs and symptoms to look out for. Some signs may need immediate attention, so don't ignore them. 

One of the main things you'll concern yourself with is pain. Of course, pain is normal after surgery. But abnormally intense pain can be the sign of an underlying problem. So be vigilant about your pain, and know what's normal and what isn't. 

Taking care of problems early on can make the difference between recovering fully or living with pain or other problems for longer than you need to.

The reason so many patients have carpal tunnel surgery is the shear prevalence of this disorder. The University of Maryland Medical Center estimates that 15% of Americans already have carpal tunnel syndrome. And some 250,000 new cases are reported each year. 

In addition, the American Association of Orthopedic Surgeons (AAOS) has another statistic. They say doctors perform over 500,000 carpal tunnel surgeries each year. As a result, carpal tunnel surgery is now the second most common operation performed (after back surgery).

Carpal tunnel release surgery is one way to eliminate symptoms. However, there are non-surgical (conservative) ways to relieve symptoms as well. The non-surgical remedies are generally more effective and far less traumatic. But there still are patients who prefer having surgery over using conservative methods.

There's no sugar coating it: after your carpal tunnel surgery, aftercare will be dominated by pain - and then more pain . And it probably will be intense in the beginning. 

However, the good news is that you'll have pain pills to help. And in time, the post-surgical pain WILL go away. 



But pain also tells you (and the doctor) how well you're doing. Exactly where the pain is located and how it feels are good indicators about your post-surgical condition.  Here's what you need to know about that pain. 

Your post carpal tunnel surgery & aftercare period should focus on these 4 questions about the pain:

1. Where is it? Pain from the incision on your palm is normal. But pain somewhere else may signal a complication. 
   
2. How intense is it? All pain after surgery is intense. But it's abnormal for pain to remain intense after 2-4 days without diminishing.
   
3. When do yo feel it?  Post-surgical pain is more manageable during the day. If pain persists morning AND night, it could be a complication.
   
4. Does it diminish with time? As days & weeks progress, pain should lessen. If not, it could be a sign of a complication or  surgical failure.

If you still have residual surgery pain, then maybe the surgery failed. Long term residual pain is a common reason for failure of carpal tunnel release surgery.

As a result of carpal tunnel surgery, aftercare will mean managing 2 types of pain: incisional and pillar.

• Incisional pain is normal. It results from cutting the skin on the palm. And it feels exactly like a deep cut in the skin that might occur anywhere else on your body. This pain normally lasts for about 7-10 days.
  
  
• Pillar pain feels different, and it's abnormal. This intense, grinding pain comes from both left and right sides of the incision. It occurs if the surgeon damaged part of the median nerve. This is the most frequent kind of abnormal pain resulting from carpal tunnel release surgery. It's also the hardest type of pain to treat. Pillar pain is considered a complication of surgery as opposed to surgical failure.
  

After any surgery there's always pain. And it's usually very intense, which is totally normal. But pain levels are subjective. Doctors consider this when asking, "How painful is it?" 

Generally speaking, if a patient complains of intense, grinding pain that not even painkillers will help, then there might be complications. Pillar pain is indeed intense, but it diminishes within a few days.

Blood vessel damage also can cause unusually severe pain, which might take longer to resolve. Finally, an infection will usually cause pain to intensify over time instead of diminishing.

Short-term prolonged pain is a complication of carpal tunnel surgery. But in the longer term, if the pain never diminishes, it constitutes a surgical failure.

Carpal tunnel surgery aftercare is mostly about  effective pain management. Your prescription pain pills should make most of the pain manageable for the first 1-3 days. After that, over-the-counter pain medicines should work just fine if your recovery is normal. 

Generally, post-surgical pain is more intense at night. This is also normal. But if pain persists at the same level during the day, it can signal an underlying problem, like infection or nerve damage. These are signs of complications following carpal tunnel surgery; aftercare (including rehab) is usually prolonged when this happens.

Patients usually feel incisional pain after surgery. This is normal. But it diminishes significantly by the third day. Those first few days are helped greatly by pain pills. After several days, over-the-counter medications can take over until pain pills are no longer necessary. This generally occurs by 7-10 days.

Unfortunately, some patients don't see a reduction of pain at all. In fact, some see an escalation of pain. These are abnormal signs. If pain persists at the same or worse intensity, then it's a sign of a surgical complication or surgical failure.

It's important to monitor pain during your carpal tunnel surgery aftercare period for 3 reasons.

1. First, as discussed above, vigilance will help you schedule medicines to more effectively manage the pain.
   
   
2. Second, careful monitoring will tell you if there's something abnormal happening.
   
   
3. Finally, the persistence of pain due to carpal tunnel syndrome (the original painful problem) is the number one indicator that the surgery was a failure. Knowing this, you can take appropriate steps to attack the problem a second time.

The failure of carpal tunnel release surgery is defined two ways. It's when a patient either:

1. Sees return of carpal tunnel symptoms within 2 years, or
   
   
2. Is dissatisfied with their results because either numbness, tingling or pain came back, persisted or worsened.
   
   

As already discussed, usually after your carpal surgery, aftercare is characterized mostly by normal post-surgical pain. But in general that pain disappears in 7-10 days. However, if the original pain from carpal tunnel syndrome becomes the main problem again, then the surgery failed. 

Overall, carpal tunnel surgery has approximately 52% failure rate. The most common reason for failure is recurrence of pain. But loss of hand strength and return of numbness also contribute to this failure rate.

Only 20% of these patients with failed results undergo a second (“revision”) surgery. But a larger proportion of those surgeries fail as well. 

On the whole, most failed surgery patients simply live with the resulting pain or other symptoms. In essence, they must forever cope with the physical, emotional, and financial scar of having a “bad surgery”.

Only 10-23% of surgical failure patients return to their previous occupation. The rest have to find another job that does not involve excessive or forceful hand activities. This is no surprise since the National Institute of Health says that carpal tunnel syndrome and occupation are definitely related.

Sadly, many patients never actually recover from the consequences of surgery. Instead, symptoms PLUS post-surgical problems persist for months or even years. In some instances it’s a lifelong ordeal.

Essentially, the statistics show that carpal tunnel surgery doesn't always live up to its promise. 

It’s not your fault that you chose hand surgery for your carpal tunnel syndrome The medical establishment and AAOS encourage having this (very lucrative) hand operation. They subtly claim it’s the “cure all” for carpal tunnel syndrome - even though doctors already know the chances of failure are high.

On the flip side, all other major health organizations’ advice is clear. Use non-surgical treatments first because they work just as well or better than surgery. Therefore, hand surgery should be your final option.

These non-surgical  treatments include night bracing, stretching exercises, and myofascial release massage therapy. A dedicated regimen consisting of all of these remedies simultaneously is a potent carpal tunnel fighter.

After you have carpal tunnel surgery, aftercare will be dominated by pain management. If you have persistent pain then it's probably a sign that the surgery failed. That means chances of a second surgery working are also very slim. However, there’s still hope to relieve symptoms. 

Use the same non-surgical remedies you should have used before surgery. They're 97% effective when used properly. They include stretching exercises, night bracing and daily myofascial release massage.