Does Carpal Tunnel Syndrome Require Surgery?

When you need your wrist, hands, and fingers to make a living or get through your daily activities, you don’t have time to deal with carpal tunnel pain. But, no matter what you do, it keeps coming back.

The carpal tunnel is a narrow tunnel of bones that runs from your wrist to your hand. Snaking through your carpal tunnel are important structures that control your fingers and thumb, such as your:

• Median nerve
• Transverse carpal ligament
• Flexor tendons

Repetitive motions, stress, and aging can irritate the tendons in your carpal tunnel, causing them to press against your median nerve, which swells and becomes tender. The result is carpal tunnel syndrome (CTS) — pain, tingling, weakness, and numbness that may make it impossible for you to use your hand at all. 

You may worry that the only way to get back to using your hand is to undergo surgery. However, surgery isn’t the only — and may not be the best — way to manage CTS.

At Addison Pain + Regenerative Medicine, expert osteopath Dr. John East treats CTS so you can get back to the work and hobbies you love. Our team offers nonsurgical pain management and treatment for CTS from our office in Addison, Texas.

Will your CTS require surgery? The following information should give you some insight.

Start treatment early

As with any condition or disease, the sooner you seek treatment for your symptoms, the more likely we can resolve them. When you’re in the early stages of CTS, reducing the inflammation inside your carpal tunnel can prevent median nerve damage.

First, we evaluate your wrist, fingers, and carpal tunnel with a variety of imaging techniques and tests. These allow Dr. East to determine how much swelling is in your carpal tunnel and whether your nerves or tissues are damaged. Tests may include:

• Nerve conduction studies (NCS) to evaluate nerve function
• Electromyogram (EMG) to measure electrical activity in your muscles
• Ultrasound to assess your median nerve 
• X-rays to look at the bones in your carpal tunnel
• Magnetic resonance imaging (MRI) to evaluate soft tissues

Dr. East also tests the sensitivity of your fingertips and evaluates how well you can flex your wrist and fingers. He may press down, tap, or flex your wrist, fingers, and thumb.

Reduce irritation and inflammation

We prescribe various medications and therapies to subdue the inflammation in your carpal tunnel and minimize the risk of damage to your median nerve. Options may include:

• Nonsteroidal anti-inflammatory drugs for pain and swelling
• Carpal tunnel injections with steroids

Steroid injections can give you relief from pain and swelling for months at a time. 

Night splints

You may need to immobilize your wrist during the day for a while as the tissues in your carpal tunnel heal. We can give you a brace to help support your wrist while you work and perform other tasks.

At night, we might recommend you wear another medical device called a splint. A splint keeps your wrist straight while you sleep to avoid irritating your median nerve.

Physical therapy and modifications

Especially if you developed your CTS due to the stress of repetitive movements, you may benefit from finding new, better ways to move your hands and wrists. Your physical therapist can design a program that works with your needs and tasks.

They may also watch how you perform repetitive tasks and make suggestions for modifications and new habits. For instance, you may need to take stretching and relaxing breaks throughout the day to avoid stressing your median nerve.

If you work at a desk, you may need to redesign your workstation to be more ergonomic. Redesigns could include adjusting the height of your monitor and the angle of your keyboard and using wrist supports to help you complete tasks without pain.

Exercises for your median nerve 

In addition to strengthening and stretching exercises for the tendons, ligaments, and muscles in your hand, you may need physical therapy that focuses on your median nerve. These are known as nerve glides or nerve flossing.

You can find nerve flossing exercises online. However, be sure you don’t overdo them, or you could damage your median nerve. Work with a physical therapist until you’re confident you can perform them in good form on your own.

If you don’t see improvement

Be sure to be patient and follow all the exercises, immobilization, and medication recommendations we give you. Over time, your CTS should improve. If it doesn’t, or if it continues to recur and interfere with your daily living, we may refer you for surgery.

Don’t give up on help for your CTS. Get the nonsurgical support you need to rehabilitate your carpal tunnel by calling our office at 972-380-0000 or requesting an appointment online today.