If you're seeking surgery to relieve carpal tunnel pain, you probably want to resolve your discomfort as quickly as possible so you can get back to life as you knew it. It's important to understand that different surgeries are available; this article intends to help you understand your options.

Carpal Tunnel Syndrome causes wrist, hand, and finger pain and numbness because a nerve known as the median nerve becomes compressed when it passes through a narrow channel within the wrist, the carpal tunnel. Creating more space within the carpal tunnel alleviates pressure on the median nerve, relieving pain and numbness. During surgery, a surgeon can widen the carpal tunnel by cutting the transverse carpal ligament, a structure that acts as the roof of the carpal tunnel.

There are different ways to approach the surgery. With the open approach, surgeons make an incision through part of the wrist and part of the palm to expose the transverse carpal ligament, which they cut through layers of fascia and muscle from above. For the past 20 years[1], surgeons looking for a less invasive approach have performed carpal tunnel surgery using the endoscopic procedure. The endoscopic procedure allows them to release the transverse carpal ligament by entering through a small incision in the wrist, essentially entering below the ligament, eliminating the need to cut through the palm. The result is a much smaller incision, faster healing time, and less overall pain[2], which is why the SmartRelease procedure is growing in popularity among surgeons and patients.

"Open releases[3], whether they involve large incisions or 'mini' open incisions, all require an incision directly through the palm," says Randy F. R. Lovell, III, MD, a board-certified orthopedic surgeon in Grand Rapids, Michigan. "The skin of the palm is highly specialized tissue, [thick] and highly innervated – lots of nerve endings. These incisions can be painful and develop tender scars for weeks, sometimes months, after surgery."

What are the benefits of SmartRelease?

The SmartRelease procedure allows surgeons to perform a carpal tunnel release without cutting into the hand's palm.

"[SmartRelease] avoids entirely any sort of incision through the sensitive palm," Lovell says. "Instead, the SmartRelease utilizes a very small incision in the forearm at the crease of the wrist and a small video camera to perform the release from the inside out."

Patients who undergo the SmartRelease procedure may be able to return to their everyday activities more quickly[4] than those who have open surgery.

With the SmartRelease procedure, surgeons can use a local anesthetic without sedation, reducing risks and shortening the post-op recovery time. 

"Now that this procedure can be performed procedure under local anesthesia – no sedation – some of our patients could walk out on their own and drive themselves home," Lovell says. "Some of my previous patients drove themselves to have their SmartRelease procedure during lunch and return to their place of work the same day."