How is carpal tunnel syndrome treated?

Carpal tunnel syndrome can be treated in two ways: non-surgically or with surgery. There are pros and cons to both approaches. Typically, non-surgical treatments are used for less severe cases and allow you to continue with daily activities without interruption. Surgical treatments can help in more severe cases and have very positive outcomes.

Non-surgical treatments

Non-surgical treatments are usually tried first. Treatment begins by:

  • Wearing a wrist splint at night.
  • Taking nonsteroidal anti-inflammatory drugs, such as ibuprofen.
  • Cortisone injections.

Other treatments focus on ways to change your environment to decrease symptoms. This is often seen in the workplace, where you can make modifications to help with carpal tunnel. These changes might include:

  • Raising or lowering your chair.
  • Moving your computer keyboard.
  • Changing your hand/wrist position while doing activities.
  • Using recommended splints, exercises and heat treatments from a hand therapist.

Surgical treatments

Surgery is recommended when carpal tunnel syndrome does not respond to non-surgical treatments or has already become severe. The goal of surgery is to increase the size of the tunnel in order to decrease the pressure on the nerves and tendons that pass through the space. This is done by cutting (releasing) the ligament that covers the carpal tunnel at the base of the palm. This ligament is called the transverse carpal ligament.

If you have surgery, you can expect to:

  • Have an outpatient procedure where you will be awake, but have local anesthesia (pain numbing medication). In some cases, your doctor may offer an IV (directly into the vein) anesthetic. This option allows you to take a brief nap and wake up after the procedure is finished. This is not a general anesthetic, like what is used in surgery. Instead, your healthcare team will monitor you during the procedure (called monitored anesthetic care, or MAC). This is also used for procedures like a colonoscopy.
  • Be in brief discomfort for about 24 to 72 hours after surgery. People usually experience complete nighttime symptom relief quickly—even the night after surgery.
  • Have your stitches removed 10 to 14 days after surgery. Hand and wrist use for everyday activities is gradually restored by using specific exercise programs.
  • Be unable to do heavier activities with the affected hand for about four to six weeks. Recovery times can vary depending on your age, general health, severity of carpal tunnel syndrome and how long you had symptoms. You will continue to gain strength and sensation in the following year after surgery.
  • Have relief from most carpal tunnel syndrome symptoms.

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