What to expect after a hand surgery

What to expect after a hand surgery

Trevor Petrie - Chief Medical Officer
7 minute read

The hand surgeries I see the most often at the practice I am at are carpal tunnel releases, trigger finger releases, and then one that maybe most people don't know about, but I see a ton of are CMC thumb arthroplasties, when they replace the joint at the base of your thumb, in response to arthritis pain.

 

There is no such thing as a 100% guaranteed surgery

The main thing to know about any surgery from any surgeon (no matter how good), is that there's no such thing as a 100% guaranteed surgery. Even a really, really good surgeon cannot guarantee you with the 100% assurity that their surgery will do everything that you hope it will do.

Carpal tunnel releases and trigger finger releases have very good outcomes. I think the most thorough study I've read on carpal tunnel releases showed that there is anywhere from about an 80%-85% satisfaction rate long-term with carpal tunnel releases, and I believe trigger fingers are right up there at around the same rate, maybe even closer to 90%.

 

Satisfaction ≠ Perfection

One thing to point out, and I always point this out to my patients too, is that satisfaction is not the same as perfection. People that are satisfied and have an improvement in their symptoms don't necessarily get a 100% improvement, that gives them the hand that they had when they were 10 years younger.

With carpal tunnel surgeries, for instance, there may be lingering paresthesia in the fingers, and there may be something called pillar pain, which is when you get a pain that runs up and down the middle of the hand. When you cut the ligament for the carpal tunnel, those little bones in the hand shift a little bit, and that can create some lingering aching pain. And that's totally normal.

Incisional pain is also very normal after almost any surgery and that can take several weeks to go away.

 

Recovery takes time

One of my more common experiences as a therapist is that surgeons tend to take a bit of a rosy vision of the recovery time from surgeries that they perform on a daily basis. So they may tell you that it'll be sore for maybe a week or two, and then you can pretty much do everything you need to do.

Whilst that does happen occasionally, for the large majority of people, there are definitely healing rates that occur. A surgery, no matter how minor it might seem, is still an injury and there are certain physiological processes that have to take place that take time.

 

Move as much as it’s safe to move

So important things to remember after any surgery, is to find out how much you can move, how much is safe to move, and move as much as you can within that parameter.

You don't want to stay absolutely still unless it's surgery for a real bad injury like a fracture or a tendon laceration that your surgeon has specifically told you cannot move. But for things like carpal tunnel tendon or trigger finger releases, even for CMC arthroplasties, you want to move everything they let you.

It’s important to find out how much is the right amount to move, and sometimes the appropriate amount of stress to help with healing is no stress. Every once in a while you just need to give it a break.

 

How long does it take to recover?

I would say, for a carpal tunnel surgery and a trigger finger release you can expect two to four weeks out even. Things might still be a little sore, they might be a little achy, pushing out of bed might still be a little painful. If you waited a long time to have a carpal tunnel release, you might have some tingling and numbness in the fingertips still. Hopefully, it will improve, but there might be a certain amount that will never come back to be 100%.

When you have surgery, it doesn't mean that you are then fixed and that everything will be fine as soon as you wake up and get the bandages off. There's some recovery to be had even with minor surgeries, but that should not be a reason to be avoidant of a surgery that might be necessary.

You don't want to wait forever to have a carpal tunnel surgery if it's gotten to the point where those fingers are totally numb or you're starting to get a little muscle-wasting. You’ve got to have something done to fix that if you ever want that nerve to come back. And again, I think an 85% satisfaction rate is a pretty good return on a surgery, even if it means it's not perfect.

CMC arthroplasties are one that I see a lot of because basal thumb arthritis is so prevalent, and I think that recovery times take people by surprise, almost more than any other surgery. After that particular surgery, most surgeons will want you to be immobilized for four to six weeks, either in a cast or a thermoplastic splint. And then when you do get moving, it's real slow.

I worked with a surgeon once that used to tell his patients “at three months, you wonder why the heck you did it, and it's six months, you'll be glad you did”. I find that for a major surgery where you do any kind of joint replacement or any kind of work on a tendon repair, or a fusion of a joint, you can expect recovery to be about 10 to 12 weeks or so.

If you look at healing at six to eight weeks, your body is dumping a ton of scar tissue in the area when it's healing from an injury or surgery. At about 10 weeks or so, everything is starting to really mature and tighten up, but you still need to stress that tissue as it realigns to resist those forces you want to put on it. At 10 to 12 weeks, all of a sudden, things might feel like they're tweaking a little bit more often. That's because that scar tissue has become matured and it's contracted and shrunk down, so it takes a little bit more, and it might be a little bit more uncomfortable to try to get that sorted out.

 

Talk to your surgeons, don’t be afraid to ask for help

So just remember, there's no such thing as a guaranteed outcome for any surgery whatsoever. Make sure that you discuss with your surgeons all the possible outcomes and what might happen – within reason, of course. Be aware of what the risks are and what the recovery is really like, and don't be afraid to ask for help if you want to go see a therapist afterwards. You want to make sure you take care of yourself.

The other thing to remember is that you might have aches and pains for much longer than you expect. But don't let that discourage you!

Make sure you keep communicating with your surgeon and keep moving everything that you can. Your body likes to move, and so that way it can heal better and appropriately so that you have a better outcome later on.


This content is presented for informational purposes only, and should not be seen as any kind of health, nutritional, medical or legal advice. You should consult a licensed medical practitioner if you are experiencing pain and/or discomfort or have a medical issue or suspect that you have a medical issue. If you choose to rely on the information presented in the Grace & Able LLC website, blog or social media posts, you do so at your own risk. 

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