Houston Methodist. Leading Medicine

Hand FAQ


I was thinking of seeing a physical therapist for my carpal tunnel syndrome. But my sister thinks I should just have surgery to take care of the problem. What do most other people do?


Treatment for carpal tunnel syndrome (CTS) is not standardized yet. Evidence from studies done so far suggest trying conservative (nonoperative) care first. If your symptoms are not improved within the first two months, then try another approach. The most common conservative care includes nonsteroidal antiinflammatory drugs (NSAIDs), physical therapy, or steroid injections (more on injections in a minute). The therapist will help you find ways to modify your posture and activities to give the nerve a rest from any tension or compression. If appropriate, you may be given splints to wear while sleeping at night. In some cases, the splints are advised on a full-time basis (day and night). They are only taken off briefly to bathe. The therapist will teach you nerve and tendon gliding exercises and perform techniques to release tension on the nerve. A form of therapy called manual therapy will be used to help realign the soft tissue and bony structures. This can also help reduce compression within the carpal tunnel. The things you will learn in therapy will help you for a lifetime. Maintaining good posture, using proper body mechanics, and modifying activities as soon as symptoms start can be very helpful in avoiding future problems. For short-term relief, a steroid injection directly into the carpal tunnel area may be therapeutic and diagnostic. There is evidence that relief after a single injection predicts a successful result after surgery. Surgery is considered an option when electrodiagnostic tests show that the median nerve is damaged. When surgery is done, the flexor retinaculum should be completely cut all the way through. This is recommended no matter what surgical approach (open, mini-incision, endoscopic) is taken. The flexor retinaculum (also known as the transverse carpal ligament) is a band of connective tissue across the wrist over the carpal tunnel. Martin I. Boyer, MD. Corticosteroid Injection for Carpal Tunnel Syndrome. In The Journal of Hand Surgery. October 2008. Vol. 33-A. No. 8. Pp. 1414-1416.

*Disclaimer:* The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.
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