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Things to consider about carpal tunnel syndrome treatment
By Mayo Clinic staffCarpal tunnel syndrome has no standard treatment program. The treatment path you take is up to you and your doctor. Most people begin by trying a sequence of conservative, nonsurgical treatments. If none of these works, you can move on to surgery.
As you mull over your treatment options, it may help to consider these key decision points and discuss them with your doctor.
How severe are your symptoms?
Carpal tunnel syndrome symptoms usually worsen gradually, which often gives you time to try nonsurgical treatments to see if you can avoid surgery. That's one reason it's important to get diagnosed and treated as early as possible.
Will nonsurgical treatments help your symptoms?
You're more likely to get relief from nonsurgical treatments if:
- You have mild to moderate symptoms that you've noticed for a year or less
- You don't have hand weakness
- Your pain is new and not severe
Are nonsurgical treatments worth trying before surgery?
Usually the answer is yes. Most people get short-term relief from a combination of nonsurgical treatments — for example, splints and corticosteroid injections. And if these treatments do help, it usually confirms that you have carpal tunnel syndrome, not a different condition with similar symptoms.
Trying nonsurgical treatments for a few months isn't likely to jeopardize the outcome of surgery, if you eventually do take that route. However, waiting several years before deciding on surgery may prolong your discomfort and make the operation less successful because your condition has worsened.
When is it time to consider surgery?
You may be a candidate for surgery if:
- Your symptoms have lasted one year or more and are either severe or worsening
- Underlying causes of your carpal tunnel syndrome have been ruled out, including arthritis, thyroid disease, diabetes and pregnancy
- Nerve conduction studies indicate moderate to severe median nerve compression
- You have hand weakness or the muscle at the base of your thumb has shrunk
- You've tried nonsurgical treatments and they don't provide adequate long-term relief
What kind of outcome can you expect from surgery?
Both types of surgery usually offer better symptom relief and hand-function improvement than does splinting or corticosteroid injections — short term and long term. Surgery promptly relieves pain in up to 90 percent of cases. Hand strength and sensation usually return more slowly. However, some degree of pain and hand weakness may persist. Recurrence of symptoms once they disappear is unusual, but does happen.
