Houston Methodist. Leading Medicine

Hand FAQ

Question:

I'm looking for some information about carpal tunnel syndrome. First, will it really improve my symptoms? And second, is it possible to come out of surgery worse than I went in?

Answer:

Carpal tunnel syndrome (CTS) is a common problem affecting the hand and wrist. Symptoms begin when the median nerve gets squeezed inside the carpal tunnel of the wrist. Another name for this medical condition is nerve entrapment or compressive neuropathy. Any condition that decreases the size of the carpal tunnel or enlarges the tissues inside the tunnel can produce the symptoms of CTS. Treatment usually begins with conservative (nonoperative) care. This can include the use of anti-inflammatory medications, wearing a splint on the wrist and hand, modifying the way you perform certain activities, and some specific exercises to help the affected nerve move through the bone and soft tissues surrounding it. You may work with a physical or occupational (hand) therapist. The main focus of treatment is to reduce or eliminate the cause of pressure in the carpal tunnel. Your therapist may check your workstation and the way you do your work tasks. Suggestions may be given about the use of healthy body alignment and wrist positions, helpful exercises, and tips on how to prevent future problems. Surgery such as you are considering is only recommended if/when nonoperative care has failed to relieve your pain or other symptoms. Three to six months of conservative care is recommended before making this decision. Studies show that the majority of patients do get significant relief from painful symptoms, numbness, and tingling. Patient satisfaction with results increases as pain decreases and normal function returns. For those who do not get better, it may be a matter of a misdiagnosis or another (second) problem in the neck, shoulder, elbow, or wrist. When there is a true carpal tunnel syndrome, symptoms rarely get worse after surgery. Isam Atroshi, MD, PhD, et al. The Six-Item CTS Symptoms Scale and Palmar Pain Scale in Carpal Tunnel Syndrome. In The Journal of Hand Surgery. May 2011. Vol. 36A. No. 5. Pp. 788-794.

*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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