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Surgery for carpal tunnel syndrome: Pros and cons
By Mayo Clinic staffWhich type of carpal tunnel release surgery you have — open or endoscopic — largely depends on your surgeon's experience and your preference. Both procedures share similar outcomes, providing:
- Excellent long-term success rates
- Low complication rates
- Restored muscle strength, manual dexterity and sensation in most cases
Comparing open and endoscopic procedures
Some surgeons strongly prefer endoscopic procedures while other surgeons just as strongly prefer open-release surgeries.
Proponents of open-release procedures believe there is less risk of accidentally damaging nerve tissue or tendons because they have a better view of the anatomical structures within your wrist. But among experienced surgeons, the complication rates between endoscopic and open-release procedures are now very similar.
Endoscopic procedures cost more than open-release procedures because they require more complex surgical instruments. This extra cost may be offset if you have less post-operative pain and can return to work more quickly. But if your return to work is accelerated by only a few days, the extra cost may not be worth it.
Also, there is always a chance that your surgeon will have to switch from an endoscopic approach to an open-release procedure if unforeseen problems arise during surgery.
Doing both hands at once
If you have carpal tunnel symptoms in both hands, you may consider having both hands operated on at the same time, to reduce the number of days you'll have to take off work. This can also lower the cost of treatment, since you're using the operating room just once instead of twice.
Although it seems logical to assume that you'd have less temporary disability after endoscopic carpal tunnel surgery on one hand than on both, there's not much difference.
Still, if you're considering having both hands operated on at once, you may want to make sure you have someone available to assist you with normal daily activities for the first two weeks after surgery.
Surgery compared with other treatments
Arguments in favor of surgery include:
- For long-term symptom relief, surgery is more effective than splinting, injection or any other nonsurgical treatment.
- Even if some symptoms remain after surgery, they tend to be less severe than those persisting or recurring after other types of therapies.
- In many cases, pain, tingling and numbness are gone immediately after surgery.
Arguments against surgery include:
- There is a slight risk of nerve damage or infection.
- Hand strength may be slow to return to normal, or not return to normal.
- Surgery may not help if another medical condition — such as obesity, arthritis or thyroid disease — is contributing to your carpal tunnel symptoms.
- You may not be able to perform your job or do other routine activities for more than a month.
