[Noah930]

If you've got the proper symptoms, they're waking you up at night/interfering with your life, you've got the confirmatory nerve test, and you've tried reasonable non-operative managment, then a carpal tunnel release surgery is the next step to take in getting better.

Carpal tunnel syndrome is the median nerve getting pinched at the wrist. The median nerve supplies sensation to the thumb, index finger, middle finger, and half of the ring finger. Probably 80% of people with symptoms have numbness or tingling in that distribution. Maybe 40% have pain (and obviously some have both). Symptoms should be on the palm side of the wrist/hand, not on the dorsum or "back." Often people will say it's worse at night and wakes them up, or they'll feel it while driving, talking on the phone, doing their hair (women), etc.

Non-operative treatment centers around reducing inflammation of flexor tendons and the median nerve at the wrist. Nocturnal splinting, oral anti-inflammatories, behavioral modification, stretching exercises, physical therapy, or a cortisone injection into the wrist area. Some people believe in acupuncture or chiropractic deep tissue massage. I'm not a big believer in laser therapy or pneumatic stretching devices; the only people who seem to tout those are the ones marketing them. The cortisone injection also can serve as a diagnostic test; it's a very directed form of treatment so if you get better (even temporarily) then it confirms that that's what you've got and that you'll likely improve if you go through with surgery.

If you need surgery one day, go with a surgeon you trust, as opposed to finding a technique on the internet or through an airline in flight magazine ad and then picking a doctor based upon that. No matter the technique, in the end the underlying surgery is the same. The surgery takes about 15-30 minutes and is often done without general anesthesia; your arm is numbed and you're given a little sedation to take the edge off of things.

Not that anyone wants elective surgery, but it's one procedure that has about a 98-99% success rate, in my experience. I do about 80 of them per year. It's the most common surgery I do. And the majority of my patient population is a very tough-to-please demographic: the workman's comp patient.

The pain that you have in the middle of the night usually goes away within the first week. The numbness and tingling may take a few weeks to a few months to get better. But overall, if the diagnosis is correct, it's a procedure with a very high success rate. Having it done endoscopically (as opposed to open) can reduce initial return to activity by a few weeks' difference, but if you fast forward a year then all patients are the same regardless of the technique used. My partner had the surgery, and he returned to work (operating) a week later. That may be a bit aggressive, but return to most activity should be possible by about 6 weeks post-op, though you may feel some nagging pain/discomfort (like when pushing out of a chair or off a mattress) for about 8 months post-op. Recurrence is possible but uncommon as the released tunnel scars back together, but with about 20% more cross-sectional space than prior to surgery.

Best of luck.