Medical Health Encyclopedia

Nevertheless, other experts argue that CTS is often progressive and will worsen over time without surgery. Furthermore, evidence now strongly demonstrates that surgery is superior to splints and conservative measures for the relief of pain.

Factors that may increase the chances for favorable surgical results:

• Having surgery performed within three years of the diagnosis of the disorder.
• Being in good general health.
• Having significantly slow nerve conduction results, but also having some preoperative muscle strength.
• Symptoms being worse at night than during the day.

Factors that may reduce the chances for success:

• Being elderly. (Although a recent report indicated that overall, 83% of patients over 65 years of age were either completely satisfied or very satisfied with their surgical outcome.)
• Having very severe preoperative symptoms.
• Being involved with very heavy manual labor, particularly working with vibrating tools. (In some studies, only slightly more than half the people who used vibrating hand-held tools were symptom-free three years after their operations.
• Having very poor nerve conduction results before surgery. (It should be noted that some patients with severe symptoms but who have normal neurologic and physical test results can still experience significant relief from CTS surgeries.)
• Being on hemodialysis. (Such patients have good initial success but about half deteriorate in about a year and a half.)
• Alcohol abuse.
• Having poor mental health.
• Diabetes and high blood pressure. Patients with these conditions may also be more likely to require a second operation.

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Factors that make no difference in results:

• Patients whose CTS is due to nerve damage from medical conditions, such as diabetes, rheumatoid arthritis, or hypothyroidism. Such patients appear to have the same outcome as those without such conditions and so such disorders should not preclude them from surgery.

Standard Release Surgical Procedures