You’re probably reading this because you're considering surgery for carpal tunnel syndrome. It's likely the pain or numbness in your hand or fingers is driving you mad. To get rid of it, your doctor recommended having hand surgery.

If you're just learning about carpal tunnel syndrome then you know this surgery is just one option you can use. And it's a popular option. In fact, after back surgery, it's the most common operation performed in the USA today - and growing fast.

Symptoms of carpal tunnel can get so bad that you’d do just about anything to stop them, including surgery. Frankly, most people feel the same way. It seems like every day a patient tells me, 

“I'm so desperate I feel like cutting my hand off to get rid of the pain."

I certainly wouldn’t recommend amputation. However, this desperation is why surgery for carpal tunnel syndrome is now so popular. So what are the "pros and cons" of having this operation?

Severe pain and numbness in your hand or fingers are primary signs of carpal tunnel syndrome. So is tingling, burning, soreness, and loss of grip strength. Usually your thumb gets the worst of it. But the little finger is never involved.

If your hand problems are indeed from carpal tunnel syndrome, then you’re not alone. In fact, one in twenty Americans either have it or will get it. And if you're a woman or pregnant your chances increase several fold.

Carpal tunnel syndrome happens because of inflamed tendons deep inside your wrist joint. Why such inflammation happens in some people and not in others is still unclear to science.

But as the tendons inflame, they swell with fluid. And as they expand, they slowly crush the median nerve adjacent to them. As the nerve is crushed it produces the carpal tunnel symptoms you now have.

There are two basic type of surgery for carpal tunnel syndrome:

• Endoscopic carpal tunnel release surgery - This is becoming more popular due to the lesser amount of trauma it causes to the hand. There are 2 subtypes: single or double portal techniques.
  
  
• 0pen carpal tunnel release surgery - This is still more widely used, but results in more hand trauma. 

Both types of surgery aim to do one thing. That is, to cut the transverse carpal ligament holding your wrist bones together.  Doing so lets the wrist bones snap apart. This, in turn, provides more room around the swollen tendons deep inside. The result is that the median nerve is no longer crushed or under pressure - and symptoms disappear.

The endoscopic type of surgery is different from the open release type in one big way. Typically, the open release method requires a 2-3 inch long cut in your palm.

In contrast, the endoscopic method only needs two (for the double portal method) or just one (for the single portal method) small holes in your hand.

The overall advantages of endoscopic surgery for carpal tunnel syndrome are many. And due to these advantages, it's becoming more and more widely used. Increasingly more doctors are learning how to perform this procedure. And most hospitals encourage using it over the open release technique.

There are several pros and cons of endoscopic surgery for carpal tunnel syndrome compared to open release surgery. It’s important for patients to know the details about each one to discuss with their doctor.

No doubt, you’ll ask your doctor’s opinion about each technique. But also ask which surgery they’re most successful at performing - or have the most experience with. Usually a doctor specializes in performing only one of them.

The "pros and cons" of endoscopic surgery compared to the open technique are listed below. Note that they're merely a summary. For more detailed comparisons, see this article.

• Endoscopic surgery for carpal tunnel syndrome needs a smaller incision, which means less trauma.
• Less pain after surgery .
• Postsurgical recovery time is shorter.
• The scar size is much smaller.
• Smaller chance of adhesion formation inside.
• Local instead of general anesthesia.
• Less chance of infection.
• Less chance of abnormal bleeding.
• Faster return to work.

• Endoscopic surgery for carpal tunnel syndrome has a greater chance of causing nerve damage.
• Greater chance of blood vessel damage.
• Higher probability of incompletely cutting the transverse carpal ligament (which means symptoms can persist after surgery).
• Less frequently performed.
• Usually more expensive.

Endoscopic surgery for carpal tunnel syndrome has given many patients the relief they need from carpal tunnel syndrome. But many others remain dissatisfied with their results because it's not a fool-proof method. With the wonderful non-surgical techniques available today, many doctors and patients ask if ANY surgery is really necessary for most sufferers. The NIH and American Academy of Orthopedic Surgeons suggest that all patients should exhaust non-surgical remedies first.