CTS Surgery: To Cut or Not To Cut


Reprinted from The RSI Network - Issue 22 - Feb'95

Tammy Crouch
February 1995

"If it looks like carpal tunnel, cut it." Is this your doctor? I hope not! But this is a quote from a real live surgeon. Thankfully this man is in the minority. Sometimes surgery is not the best way to treat the symptoms of CTS, yet it's still recommended in a number of cases where, with a little detective work and time, the problem could be handled in a much less invasive manner. Unfortunately, some patients (and I am one of them) don't find this out until they've undergone one, two, or even more surgical procedures that just didn't work.

To be fair, surgery can work wonders for some CTS patients. Generally, these patients have given conservative care a try and found that alternative therapies didn't help. Or they may have been so far along by the time they sought medical advice that it was too late to try a conservative course of treatment. But although surgery does work for some people, a few myths persist about the surgical treatment of CTS:

* It's a simple procedure.
Well, yes and no. Compared to a coronary bypass, it's a day at the beach! But it is still surgery, with all the risks that entails, including anesthesia, scarring, and so on.
* It works for everyone.
False. If your doctor makes this claim about this or virtually any other surgical procedure, run.
* Have surgery at the first sign of CTS.
Definitely false! Even if you do have a genuine case of CTS (which you'll only know after complete orthopedic and neurological studies), depending on what stage you're in there may be a number of options available to you. The problem is, it may be like pulling teeth to get your doctor to give you accurate and unbiased information about them!

What can you do in the early or even middle stages of CTS to reduce the likelihood that surgery will be required? First, the obvious: rest. If you're involved in an activity that's injuring your wrists and hands, take a hard look at what you can do to relieve the stress. Next, learn about home care: applications of ice and/or heat, paraffin baths (my favorite), eating well, stretching, strengthening your entire body, stress reduction - all simple, low-cost ways to take care of yourself. When a woman who was scheduled for her second surgery told me her symptoms were worse in the morning, I asked her about her pillow. She said it was old and uncomfortable, not providing much support for her head and neck; she got a new pillow and felt better within days (she canceled the surgery). Check into alternative therapies like chiropractic, massage, acupuncture, vitamin B6, herbs, and homeopathy. Physical therapists can often provide significant relief and reduction in inflammation with the various forms of electrical therapy at their disposal.

The bottom line is, surgery may or may not be the answer in your particular case. But with CTS, as with any condition, it pays to become an informed participant in your own health care. When your health is at stake and you're in pain, it's difficult to get out there and dig up the information you need, to ask questions, or to challenge your doctor. But it's your right to know what you're getting into with any treatment, and your best chance for a full recovery lies in your ability to make informed decisions about your health care.

About the Author
Tammy Crouch (tmc909@aol.com or BDJA62A on Prodigy). Tammy is the author of Carpal Tunnel Syndrome & Overuse Injuries: Prevention, Treatment, and Recovery, North Atlantic Books, 1992.

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Last Updated: 10/21/00