- Steroid shots have a success rate of 45%.
- Some patients feel relief within a day while others require 1-2 weeks (or more) for relief.
- If the injection works, relief can last 4-6 months.
- More than 50% of patients will have symptoms return within 6 months.
- Over 75% of injected patients will elect to have surgery within one year.
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Treatment: Carpal Tunnel Syndrome
Dr. Z • Apr 23, 2022
Treatment: Carpal Tunnel Syndrome
Imagine getting rid of the crushing numbness and pain of carpal tunnel syndrome forever. You can! In fact, you have several choices for its treatment. Carpal tunnel syndrome can be eliminated completely so it never bothers you again using the remedies below.
Will you beat the odds?
About 46% of the time, mild stage (less than 6 months old) carpal tunnel syndrome will disappear by itself, without treatment. That percentage is much lower for moderate or severe stage patients.
Don't take any chances. If your symptoms worsen, your life will be many times more miserable.
FACT: Doctors diagnose over 8 million people a year with carpal tunnel syndrome. About 260,000 of them decide to treat it with surgery. The remainder (7.4 million) use non-surgical remedies.
While most patients choose non-surgical remedies, they must be used diligently and properly in order to permanently eliminate carpal tunnel symptoms.
This article details the Surgical and Non-Surgical treatments available. You'll learn the pros and cons of each treatment, and which ones doctors and patents recommend most often.
Non-surgical carpal tunnel treatments
Doctors usually prescribe one or more non-surgical methods to relieve carpal tunnel syndrome. In fact, the American Academy of Orthopedic Surgeons (those who regulate hand surgery) actually recommend patients use one (or more) of the following 6 remedies before considering surgery. Why? Because they work for most carpal tunnel sufferers.
The non-surgical remedies described below are the most common ones recommended by doctors, physiotherapists, and chiropractors. If your carpal tunnel symptoms are mild, any one of these remedies will usually provide good results. If your symptoms are severe, you may need two or more of them at the same time.
1. Steroid injections
2. Night bracing
- Night bracing is 50-95% effective when symptoms are mild to moderate.
- Night bracing alone is not effective when symptoms are severe.
- A certified carpal tunnel brace is required. (Drug store braces are harmful for carpal tunnel.)
- Braces are a relatively inexpensive option.
- Can be used in combination with most other therapies.
3. Myofascial release massage
- Myofascial release massage treats the underlying cause of carpal tunnel syndrome (flexor tendon adhesions).
- Physical therapists have 80% to 90% success rate.
- Myofascial release using the CarpalRx massager has a 97% success rate.
- Massage must be used daily for at least 3-6 weeks (depending on symptoms severity).
- Large return on investment: high efficacy rate for a relatively small cost.
4. Stretching exercises
- These stretching exercises are quick and easy to do.
- Exercises directly target inflamed flexor tendons (which cause carpal tunnel).
- Results appear in about a month when performed every 2-4 hours.
- 51% of patients see symptoms severity cut in half by 3 months.
- About 93% of patients see "good" or "excellent" results by 8 months.
- Can be used in combination with most other therapies.
5. Yoga
- Proven effective against carpal tunnel in multiple clinical trials.
- Enormous volume of anecdotal reports of its success with carpal tunnel.
- Long-term carpal tunnel pain relief when yoga is incorporated into your daily life.
- Twice daily yoga exercises will keep carpal tunnel symptoms away permanently.
- Yoga provides additional wellness benefits.
6. Pain medicines
- NSAIDs (non-steroidal anti-inflammatory drugs) are the most common treatments for carpal tunnel symptoms.
- These drugs include Advil, Tylenol, Naproxen, and Motrin.
- NSAIDs have up to 79% success rate against pain.
- They do not effectively relieve tingling, numbness, or weakness.
- The drugs provide only temporary pain relief. (Once the drug wears off in a few hours, pain returns.)
- NSAIDs can pose significant health risks such as liver and kidney damage with long-term use (more than a few weeks of continuous use).
- Not a good long-term solution to treat carpal tunnel syndrome.
Surgery for carpal tunnel syndrome
Doctors diagnose over 8 million people a year with carpal tunnel syndrome. And about 500,000 of them decide to treat it with surgery. The remainder use non-surgical remedies.
The technical term for this hand operation is "carpal tunnel release surgery". It's specifically designed for relieving symptoms of carpal tunnel syndrome.
Doctors perform the surgery in one of two ways: open or endoscopic. You will have one of these procedures, depending on which one your doctor is comfortable and experienced with.
Both of these surgical techniques have a success rate of about 50%. This is based on patient satisfaction at 6 months. The primary reasons for dissatisfaction (including patient complaints) are:
- Persistent pain
- Symptoms didn't resolve
- Symptoms returned
- Poor hand function & weakness
What to expect during carpal tunnel surgery
Both operative procedures are generally performed on an outpatient basis.
For the open technique, you're usually given an intravenous general anesthesia which puts you to sleep. For the open technique, you're generally given a nerve block in the arm which deadens your hand while you remain awake.
The doctor then makes the incision in your hand.
- For open surgery, you'll have a 2-3" long incision from your wrist to your palm.
- For endoscopic surgery, you'll have either one or two small holes in your hand.
The incisions allow the doctor to see the transverse carpal ligament. This ligament is a band of tough tissue connecting both sides of your hand. The doctor uses a scalpel to cut the ligament. When cut, the ligament lets your wrist bones snap apart. This relieves pressure on the median nerve directly beneath it.
Open carpal tunnel surgery takes 40--20-30 minutes. Endoscopic surgery takes 40-60 minutes. Once the operation is complete, the staff wraps bandages around your hand. When you're fully awake (1-2 hours later) you're sent home to recover.
The surgical staff will give you special written instructions to follow at home.
Comparison of carpal tunnel surgery techniques
Open carpal
tunnel surgery
- Requires 2-3" long incision.
- More than half the rate of accidental damage to a nerve, blood vessel or tendon.
- Six times fewer cases of median nerve damage.
- Scars are larger and more sensitive.
- About 32% less expensive.
- More post-surgical pain and longer recovery time.
- Requires more extensive
aftercare.
Endoscopic carpal
tunnel surgery
- Requires one or two small holes.
- More than half the rate of complications.
- Faster full recovery (weeks vs months)
- Better overall recovery of function.
- Faster return to work (1-2 weeks vs 4-6 weeks)
- Results in smaller, less sensitive scar(s).
- More expensive.
- Performed by only 20% of hand surgeons.
Summary
Choose the right treatment! Carpal tunnel syndrome CAN be eliminated -- provided you use the proper treatment at the right time. Surgery is one option, and it can be done in one of two ways: open or endoscopic. But most patients choose to use one or more non-surgical remedies first. That's because they work extremely well for most patients. The most common non-surgical remedies are steroid injections, night bracing, myofascial release massage, stretching exercises, yoga, and pain medicines.