Nerve
Guyon’s Canal Syndrome
Mild cases may be managed with activity modification, splints, or, in selected situations, targeted injections to ease inflammation. When symptoms persist or weakness develops, surgical release may be recommended to relieve pressure and protect the nerve.
During surgery, a small, carefully placed incision at the wrist allows gentle decompression of the canal, freeing the nerve and its motor branch. The goal is to restore natural sensation and movement while preventing further irritation — helping the hand feel light, strong, and responsive once more.
Procedure time
30–45 minutes
Anaesthesia
Local, regional, or general
Discomfort
Mild; settles over days
Dressings
~2 weeks
Light use
From 1–2 weeks
Work
Desk: ~1–2 weeks · Manual: 3–4 weeks
Sports
Gradually after 4–6 weeks
Final result
Sensation/strength improve over weeks–months
Treatment may involve releasing the nerve from surrounding scar tissue, correcting its course, or gently reconstructing the protective environment using soft tissue or fat flaps. In some cases, nerve wrapping or targeted neurolysis is performed to relieve tethering and reduce pain. Recovery is typically more gradual, as nerves take time to regenerate, but careful technique and structured aftercare can restore comfort, sensitivity, and confidence in movement.
For complex injuries or long-standing compression where nerve recovery is incomplete, nerve reconstruction or nerve transfers may be considered. Nerve reconstruction bridges damaged segments using nerve grafts or conduits, while internal neurolysis can free nerves from focal scarring. Nerve transfers involve redirecting a healthy donor nerve branch to reanimate a lost function — for example to restore fine hand movement, to recover wrist or finger extension or to improve thumb or index flexion, in select cases.
Timing is critical — earlier intervention (typically within months) offers the best chance of meaningful recovery.
Rehabilitation is an essential part of recovery, including tailored hand therapy to retrain nerve pathways, sensory re-education, splinting where needed, and progressive strengthening. Each programme is carefully designed in partnership with specialist therapists to support the gradual return of function, dexterity, and confidence in the hand.
FAQs
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1. What causes Guyon’s canal compression?
The ulnar nerve becomes compressed at the wrist. Common causes include cycling, repetitive pressure on the palm, wrist ganglions, fractures, or sometimes no clear origin.
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2. How is it diagnosed?
Diagnosis is based on symptoms and examination. Nerve tests (electrophysiology) or ultrasound may be used when needed, especially to distinguish from cubital tunnel syndrome.
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3. Will I need surgery?
Not always. Mild symptoms may improve with activity modification, splinting, or treating underlying causes such as cysts. Surgery is recommended for persistent numbness, weakness, or if structural compression is found.
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4. What symptoms improve after surgery?
Tingling and discomfort often improve early. Strength — especially grip and small-muscle strength — takes longer, depending on the nerve’s health before surgery and your healing capacity.
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5. Is recovery painful?
Most patients experience only mild to moderate discomfort, which is well controlled with simple pain relief. Gentle wrist and hand movement is encouraged early to prevent stiffness and support recovery. You will also be guided throughout by your hand therapist, who will tailor exercises and strategies to keep you comfortable and progressing well.
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6. When can I drive and return to work?
You can usually return to driving once you feel confident that you can safely control the vehicle, which for most people is around 1–2 weeks after surgery.
Desk-based work is typically possible at about 2 weeks, depending on comfort and swelling.
For manual, physical, or tool-based jobs, recovery time is longer. Most patients need 3–6 weeks, and heavier or repetitive roles may require even more time. Your return-to-work plan will be tailored to the specific demands of your job.
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7. Can the condition recur?
Recurrence is possible but uncommon when underlying causes are addressed. If symptoms do come back, full evaluation is offered to identify any additional compression points.
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8. Is this covered by insurance?
Yes. Guyon’s canal release is covered by all major insurers.
