How is carpal tunnel syndrome treated?
Non-surgical treatments are usually tried first. Treatment begins with wearing a wrist splint at night and taking nonsteroidal anti-inflammatory drugs, such as ibuprofen, to relieve pain. Cortisone injections can also be given though they provide only temporary relief of symptoms, but may provide evidence of confirmation of the diagnosis. In addition, changes to the work station can be made. Examples include raising or lowering the chair or the computer keyboard to bring the patient into proper alignment. Changes in the hand/wrist positions used in jobs and other activities can also be tried, along with activity modification.
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 pressure on the nerves and tendons that pass through the tunnel. 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.
Surgery for carpal tunnel syndrome is an outpatient procedure that is usually performed under local anesthesia (you will be awake) but sedation can be added for comfort. After surgery, brief discomfort lasts 24 to 72 hours. However, patients often experience complete nighttime symptom relief even the night after surgery. Stiches are removed 10 to 14 days after surgery. Hand and wrist use for everyday activities are gradually restored using a specific exercise program.
Heavier activities with the affected hand are restricted for 4 to 6 weeks. Recovery times vary depending on the patient’s age, general health, severity of carpal tunnel syndrome, and the length of time symptoms have been present. Strength and sensation continue to improve over the following year.
Many patients who undergo carpal tunnel release surgery achieve nearly complete relief of all symptoms. Recovery in some individuals with severe carpal tunnel syndrome may be slow and may not be complete. Carpal tunnel syndrome can reoccur, but this is not common.