Question:I'm just about ready to retire from my job as a billings analyst. My carpal tunnel seems to be getting worse every year. The doctor thinks I should have carpal tunnel surgery now. If I had less pain, I might be able to work longer. She wants me to have electrical nerve tests done first. After six months of pain and numbness, is this step really necessary?
Answer:A recent study showed that patient report of symptoms and the results of electrodiagnostic testing does provide different information. Sometimes patients have ongoing symptoms but no changes in nerve function. These people may benefit more from conservative care than surgery.
In other cases, the median nerve gets pinched or compressed as it goes through the circle of bones in the wrist (the carpal tunnel). Testing will be able to demonstrate the need for surgery.
There's been some suggestion that psychologic factors are important in chronic pain problems. Patients who are depressed, anxious, or dissatisfied at work have more intense, longer lasting symptoms. Surgery won't necessarily change the picture. A job change or even retirement may be much more effective.
Experts advise physicians (especially surgeons) to use patient report of symptoms and function along with electrodiagnostic results when deciding to do surgery. If your physician suggested nerve conduction velocity tests, it's likely a very necessary step in the decision process.Leighton Chan, MD, MPH, et al. The Relationship Between Electrodiagnostic Findings and Patient Symptoms and Function in Carpal Tunnel Syndrome. In Archives of Physical Medicine and Rehabilitation. January 2007. Vol. 88. No. 1. Pp. 19-24.
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