Only a small percentage of patients require surgery. Factors leading to surgery include the presence of persistent neurological symptoms and lack of response to conservative measures. If the patient experiences severe pain that cannot be relieved through rest, rehabilitation or nonsurgical management, he or she may be a candidate for one of several surgical procedures that can be performed to relieve pressure on the median nerve. The most common procedure is called carpal tunnel release, which can be performed using an open incision or endoscopic techniques.

The open incision procedure involves the surgeon opening the wrist and cutting the ligament at the bottom of the wrist to relieve pressure. 

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Information sourced from https://www.aans.org/Patients/Neurosurgical-Conditions-and-Treatments/Ca...