Open carpal tunnel release surgery requires the surgeon to make a 2"-3" long slit in your hand. Then the doctor cuts a ligament between your wrist bones together. The bones separate, thus relieving pressure on the nerve below.

Find out more about open carpal tunnel surgery here.

Advantages of this Therapy

1. More frequently used: More than twice as many hand specialists are trained to perform this operation.
2. Higher success rate: The doctor can easily see the structures inside the wrist. This assures the ligament is completely cut. 
3. Fewer complications: The doctor can visualize the surgical field better. This avoids making mistakes like accidentally cutting or nicking other important tissues like blood vessels or nerves. 
4. Fewer failures: Since the surgeon can see the operative field clearer, it's easier to cut the ligament completely.
5. Lower cost: This type of surgery for carpal tunnel is cheaper to perform because special instruments and training are not required.

Disadvantages of this Therapy

1. More painful: The long incision causes more trauma to the hand. This results in more post-surgical pain. Often the pain lasts up to 2 weeks later.
2. Longer post-surgical recovery time: The greater amount of trauma results in a longer time for the hand to return to normal. Sometimes this can last months.
3. Extensive aftercare: Extensive hand trauma requires special surgical aftercare.
4. Return to work: Due to the longer recovery time, returning to work, especially if using your hands is necessary, will take longer. Typical time to return to work is after 2 months.
5. More extensive hand rehabilitation: Both surgical techniques require rehabilitation to regain hand strength and dexterity. But the more traumatic the surgery, the more rehabilitation is required.
6. Larger scar & scar complications: The larger scar causes special scar-related complications like extensive pain, scar hypertrophy, and hyperesthesia.
7. Lower satisfaction rate: Patients report being less satisfied with this technique compared to the endoscopic technique.

Endoscopic carpal tunnel release surgery means the doctor performs the same operation as above. But instead of a long skin incision, the doctor uses an endoscope. The endoscope is a thin tube with a tiny camera at the end so the doctor can see inside your wrist. 

It’s inserted into the wrist through a small hole in the skin. Usually, another tube is inserted into a different small hole cut into the palm. It contains the scalpel used to cut the ligament holding your wrist bones together.

Find our more about carpal tunnel surgery here.

Advantages of this Therapy

1. Local anesthesia: This technique lends itself to using a nerve blcok. That means the patient avoids general anesthesia, and the nausea and complications which are often associated with it.
2. Less painful: The lesser hand trauma (from one or two small holes in the skin) means less post-surgical pain than the open technique.
3. Shorter post-surgical recovery time: The small skin incision(s) mean less trauma to the hand. This allows the patient to recover faster - usually in a matter of 1-2 weeks. 
4. Less extensive aftercare: There is little special post-surgical aftercare required compared to the open technique.
5. Quicker return to work: Since recovery shorter, return to work is typically 1-2 weeks. This is slightly longer if you use your hands extensively on the job.
6. Less extensive hand rehabilitation: Both types of surgery for carpal tunnel require hand rehabilitation. However, the small incisions and less trauma of this technique mean a shorter rehabilitation time – often under a few weeks.

Disadvantages of this Therapy

1. Less frequently used: Endoscopic surgery for carpal tunnel requires special training and specialized equipment. Therefore, fewer surgeons use it.
2. Higher failure rate: Since the surgeon has only a limited visual field through the small endoscope, it's easier to incompletely cut the ligament.
3. More complications: The probability of cutting or damaging other structures due to a lower visibility means blood vessels or nerves can be damaged. This results in more complications using this technique.
4. More expensive: Due to the special training and specialized equipment, this operation is more expensive than the open technique.
5. Higher satisfaction rate: Overall, patients are more satisfied with this procedure.

Steroid (also called corticosteroid) injections are the most common method used by doctors to relieve carpal tunnel symptoms. 

Steroids work by reducing inflammation around the tendons. This then reduces swelling and subsequent pressure on the median nerve. As a result, symptoms disappear.

Symptoms generally resolve, within 1-2 weeks of the steroid injection. However, in many patients symptoms don't resolve fully, and sometimes not at all. The success rate usually depends on 2 major factors: how severe the carpal tunnel symptoms are, and how long you've had them.

Find out more about steroid injections here.

Advantages of this Therapy

1. Inexpensive: The typical out-of-pocket cost of a corticosteroid injection for carpal tunnel syndrome ranges from $350-$450.
2. Quick and simple procedure: The injection only takes minutes.
3. Mixed results:  Steroid injections for carpal tunnel are fully effective about 45% of the time. Most patients see some relief. 
4. Use during pregnancy: Unlike where surgery is contraindicated (ad in pregnancy), steroid injections are generally safer to use.

Disadvantages of this Therapy

1. Not a long-term solution: The effects of the steroid injection wear off in about 3-6 months. At that point, 60% of patients require another injection.
2. Usually requires more than 1 injection: Since the effects of the injection wear off, you need another afterwards. But you can only have a limited number of steroid injections per lifetime because of potential side effects. 

Physiotherapists, chiropractors, and massage therapists use a physical therapy technique known as myofascial release massage to treat carpal tunnel syndrome.

This is actually an ancient remedy applied to a new problem. For decades, myofascial release massage has been used to successfully treat the condition in lieu of surgery. For carpal tunnel syndrome to resolve completely, tendon inflammation must be reduced. But tendons inflame due to irritation.

Therefore, the best long-term solution is to eliminate the underlying reason why tendons inflame. That reason is adhesion formation which ocurfs between tendons. Thus, remove the adhesions and irritation decreases -- so inflammation never happens to begin with.

Myofascial release massage produces a kneading motion on the skin, above the flexor tendons (whose inflammation causes carpal tunnel syndrome). Typically, patients require one or two massage sessions per day. Carpal tunnel symptoms are normally completely relieved in about 30 days.

Find out more about myofascial release massage here.

Advantages of this Therapy

1. Highly effective: Myofascial release massage is effective in completely or near-completely relieving carpal tunnel symptoms in about 97% of patients with moderate or severe symptoms.
2. Low cost: Seeing a therapist for myofascial release massage every day ($30-$50/session) for 30 days is relatively inexpensive compared to surgery.

Disadvantages of this Therapy

1. Must be performed daily: Practitioners advise at least once per day treatment using myofascial release massage. Twice daily is optimal. Results are obtained in about 30 days for moderate level symptoms. (However, the CarpalRx , a medical device, performs myofascial release massage automatically.)
2. Cannot treat yourself: The kneading motion which is crucial to the technique requires two thumbs to produce semi-circular motions. You cannot perform this on your own wrist. However, this technique can be taught to a partner.