Carpal tunnel treatment — doctor guides decisions

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Carpal tunnel treatment — doctor guides decisions


Peter Amadio, M.D., a Mayo Clinic hand surgeon

It's essential because the treatment decision is based on things that the doctor brings and things that the patient brings. The doctor is the person who's in the best position to tell you how bad the carpal tunnel syndrome is and what's likely to happen to the nerve with various kinds of treatment or if you choose not to have treatment. But the patient, you the patient, you're the only one that knows how bad it bothers you and that also has to be a very important part of making a treatment decision. Because if it doesn't bother you very much, even if it's relatively bad, well then we need to think a lot more about adding risks or adding the potential for complications because we certainly don't want to make you worse. On the other hand, even if the problem is relatively mild, if it bothers you a lot, then that might push us to be a bit more aggressive as far as treatment. So it's very, very important that the doctor and the patient be partners in the decision. Neither one can make a perfectly informed decision without the other.

The long-term results after carpal tunnel surgery are usually pretty good. The risk of re-operation is very small. Even at the most extreme, it's probably less than a 5 percent chance that you might have to have the operation done over again. So usually the result is good from that regard that additional surgery isn't likely to be necessary. However, it's important to remember that most people who have carpal tunnel syndrome, if you ask them closely, will say that they do have some residual problems in that hand. The hand is not perfectly, completely normal like it was when they were young, younger and healthier. There might be some tenderness in the palm, there might still be some numbness or tingling in the fingers with activities, there might be some weakness of grip or some easier fatigue ability in that hand, so it's important to remember that the result is not a perfectly normal hand as if nothing were ever wrong with it. But usually it's a much improved hand with much less in the way of numbness and tingling — a stronger grip, better dexterity and a better ability to do everyday activities.

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Last Updated: 2010-04-17
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