Does Carpal Tunnel Syndrome Require Surgery?
Whether you lived with chronic wrist and hand pain for months or years before you finally received an official diagnosis, you’re probably more than ready to explore more targeted treatment solutions now that you know you’re dealing with carpal tunnel syndrome (CTS).
If your CTS symptoms are persistent, severe, or worsening, you may be wondering if it’s possible to attain long-lasting relief with a conservative care approach — or if minimally invasive surgery is your best treatment option.
Read on as our board-certified orthopedists at Sports Medicine Oregon discuss the ins and outs of CTS, including when we typically recommend carpal tunnel release surgery.
Understanding carpal tunnel syndrome
Your median nerves allow you to move and feel your forearms, wrists, hands, and fingers. Starting at the shoulder, these vital conduits of sensory signals and motion run down the inside of each arm, pass through each wrist and extend into the palms of each hand.
Median nerve pressure
CTS symptoms occur when the median nerve becomes compressed within the small, rigid passageway inside your wrist — an area called the carpal tunnel. Made of carpal bones and stabilizing ligaments, the carpal tunnel houses movement-facilitating tendons alongside the median nerve.
Common CTS symptoms
Anything that causes the narrow space inside the carpal tunnel to become even tighter can press on the median nerve and give rise to pain, tingling, numbness, and weakness in your wrist and hand. Unfortunately, CTS is a progressive condition that gradually worsens without intervention. As it advances, you may start to experience more severe or persistent symptoms like:
- Numbness and/or decreased sensation in your fingertips
- Tingling and/or “electric shock” sensations that travel up your arm
- Hand weakness that makes it hard to grasp an object firmly
Most people only develop CTS symptoms in their dominant hand/wrist.
Various possible causes
CTS isn’t a problem with the median nerve itself; instead, it’s the result of one or more problems that shrink the space inside the carpal tunnel and place increased pressure on the median nerve. Often, it’s the product of a combination of factors, ranging from small wrist anatomy and joint injury to chronic fluid retention and inflammatory arthritis.
CTS risk factors include older age, female gender, and an occupation, sport, or hobby that requires repetitive wrist and/or finger movements.
Most cases of CTS don’t require surgery
Early intervention offers the best chance at improving CTS without surgery and preventing long-term median nerve damage. Depending on the nature, severity, and duration of your symptoms, your treatment plan may require you to:
- Rest the affected wrist/hand until your symptoms subside
- Wear a supportive wrist-hand orthotic, especially during sleep
- Take OTC anti-inflammatory pain medicine for short-term relief
- Calm severe CTS pain flares with periodic cortisone injections
Once these strategies have eased your symptoms, engaging in other therapies can help address the underlying problem and control the condition long-term.
Physical therapy aims to improve your wrist/hand strength and mobility with a series of daily exercises and stretches. Occupational therapy shows you how to alter your movement patterns if your job requires repetitive wrist and/or finger motions, as well as how to make ergonomic changes that place minimal stress on your wrists.
Furthermore, if your CTS is linked to an underlying condition like rheumatoid arthritis (RA), controlling that condition can go a long way in alleviating CTS symptoms.
When surgery is the best option for CTS
Most cases of mild to moderate CTS respond well to conservative treatment, triggering fewer and less severe symptom episodes with attentive care. Still, sometimes surgery is the best option. You may be a candidate for carpal tunnel release surgery if:
- Conservative care doesn’t ease your carpal tunnel symptoms enough
- You have severe CTS symptoms that increase your risk of nerve damage
- Imaging tests show that the affected median nerve is already damaged
To perform carpal tunnel release surgery, our team makes a simple incision in the transverse carpal ligament that connects your wrist to your palm. This effectively reduces tension on the carpal tunnel and creates more space for your tendons and median nerve. Whenever possible, we use minimally invasive surgical techniques.
Most people who can benefit from carpal tunnel release surgery experience substantial improvement after the procedure, with fewer to no symptoms and better hand function.
Ready to attain long-term relief from CTS?
Whether you need help managing mild CTS or you’re considering surgery for severe CTS, our Sports Medicine Oregon team can help. Call or click online to schedule a visit at your nearest location in Tigard or Wilsonville, Oregon, today.