Carpal tunnel syndrome affects millions of people, causing numbness, tingling, and pain in the hand and wrist. While surgery is often the best solution for long-term relief, the type of carpal tunnel release you choose can significantly impact your pain, recovery time, and overall outcome.

Despite overwhelming evidence supporting endoscopic carpal tunnel release, 8 out of 10 hand surgeons in the U.S. still use the traditional open method. But why? And what does this mean for patients?

At Nebraska Hand & Shoulder, Dr. Dolf Ichtertz specializes in endoscopic carpal tunnel release, helping patients recover faster with less pain and no visible scarring. Here’s what you need to know about your surgical options.

Three Major Techniques for Carpal Tunnel Release

There are three primary approaches to carpal tunnel surgery, but only two are widely used:

1. Open Carpal Tunnel Release (Traditional Method)

• Used by 80% of U.S. hand surgeons
• Involves a large incision in the palm
• More post-surgical pain and a visible scar
• Longer recovery time

2. Endoscopic Carpal Tunnel Release (Minimally Invasive) 

• Smaller incisions (⅜ inch or smaller)
• Faster healing, less pain
• No visible scarring once healed
• Lower risk of complications like wound dehiscence (wound reopening)

3. Mini-Open Carpal Tunnel Release (Less Common)

• Smaller incision than traditional open surgery
• Not as minimally invasive as endoscopic
• Recovery time varies

Of these three options, endoscopic carpal tunnel release offers the fastest recovery, the least pain, and the best cosmetic results. Research has even compared patients who had open release on one hand and endoscopic on the other—every single patient preferred the endoscopic method.

Why Endoscopic Carpal Tunnel Release Is the Better Choice

Many American surgeons stick to tradition, continuing to use open carpal tunnel release, despite clear evidence that endoscopic surgery is superior. For patients, this means unnecessary pain and prolonged recovery.

Here’s why endoscopic release is the best option:

• Smaller Incisions – Just two tiny incisions (⅜ inch or smaller) instead of a large palm incision.
• Less Pain & Faster Recovery – Most patients return to normal activities within 24 hours.
• No Visible Scar – Unlike the open procedure, where scars can remain prominent.
• Lower Risk of Wound Dehiscence – No worry about stitches popping open.
• Minimal Tissue Damage – Preserves surrounding structures for better healing.
• Quick Return to Work – Many patients resume work within a day, while others may take up to a week depending on job requirements.

There’s no difference in long-term success rates between open and endoscopic surgery, but the recovery process is drastically different. Why endure more pain and months of healing when a better option exists?