There are two explanations for pain persisting after carpal tunnel release.

What is a carpal tunnel release?

The median nerve and tendons pass through a narrow passageway in the wrist: the carpal tunnel, formed at the wrist bones on the bottom, and the transverse carpal ligament that goes across the top of the wrist.

The tissues will swell when this area is tight (or injured), causing pressure on the median nerve: hence the numbness and tingling, sometimes pain.

In the release procedure, the ligament that’s pressing on the carpal tunnel is cut, making more room for the median nerve/tendons to pass through.

  • So why, then, can the pain, numbness and tingling continue after this procedure?
  • After all, it seems like a pretty straightforward fix.

“Pain after a carpal tunnel release can be due to either persistent carpal tunnel syndrome or recurrent carpal tunnel syndrome,” says Jonathan Oheb, MD, Chief of Orthopedic Hand and Upper Extremity Surgery at North Valley Orthopedic Institute.

Dr. Oheb explains, “Persistent pain, in which the pain never improves after surgery, can often be due to an incomplete carpal tunnel release.

“This is differentiated from recurrent carpal tunnel syndrome in which the pain resolves and then recurs over the course of time as scar tissue that forms places pressure back over the median nerve.”

Scar Tissue Formation

This is not an uncommon complication after carpal tunnel release.

The carpal tunnel, having been snipped, triggers a healing response from the body, resulting in excessive scar tissue in some cases.

Nearby soft tissues then get bound together, and the skin nearby may feel tight.

Hand and wrist movement may feel restricted.

But that’s not all. The scar tissue can bind the median nerve and tendons, keeping them from smoothly gliding within the carpal tunnel. Pain is the result.

If the pain can’t be managed, then a second carpal tunnel release may be performed.

In addition to hand, elbow and shoulder care, Dr. Oheb provides comprehensive surgical and nonsurgical treatment for all orthopedic conditions of the hip, knee and ankle, including broken bones and injuries.
Lorra Garrick is a former personal trainer certified through the American Council on Exercise. At Bally Total Fitness she trained women and men of all ages for fat loss, muscle building, fitness and improved health. 


Top image: Shutterstock/Orawan Pattarawimonchai