Carpal-Tunnel clinic

enna
Offline

Hello,
I attended the clinic on the 11th February this year and was offered splints, injections or operation. I chose to use the splints and was advised to wear them overnight for four to six weeks. I have done this but, although initially the symptoms seemed to subside, there is no true improvement. What is the next step I should take?

jeremydpbland
Online

The options now are either to try local corticosteroid injection or else to proceed to surgery. As your worst hand is grade 3 I have no strong preference for one course of action or the other. I'm sure Emma will have discussed the pros and cons of each when she saw you but all of the information we have on the likely resuts of both courses of action are here on the website in the treatment pages to refer to. It's probably also worth reading the sections on surgical prognosis and non-surgical prognosis as they tell you what is known about which patients do well, or badly, with each option. You are welcome to ask further questions directly on here before making a decision too.

Once you have had a think about that we can arrange either injection or surgery for you. If you are genuinely undecided we can also enter you into a clinical trial (INDICATE) which would randomly allocate you to either injection or surgery (50/50) and then we would follow up how you do for the next year. Eventually this may give us information which will help subsequent patients to make the same decision you are facing now. JB

enna
Offline

I have followed your advice and have read and re read the research concerning surgical and non surgical prognosis. Taking into account in my age and the grade of C-P in my worst hand I felt surgery would be my best option. However, although initially after wearing the splints for 6 weeks I saw no improvement I have noticed during the last week or so the numbness and tingling in both hands has decreased! I have not worn the splints during this period. Is this normal, or could it be due to the fact that I have been taking paracetamol for arthritis on a more regular basis, or simply a placebo effect? I have experienced more pain in my thumb and middle finger of late but think this is more of an arthritic than nerve pain. I'd appreciate your advice before definitely opting for the operation. With many thanks.

jeremydpbland
Online

CTS can fluctuate in severity over time even with no treatment at all so in an individual case it is often very difficult to decide what has actually made a difference. If there is real uncertainty about which way it is going we can always test it again to get an objective measure. JB

enna
Offline

Thank you for your reply.
Having just driven for fifty miles I experienced only the slightest tingling in my right hand at the end of the journey. I think therefore bearing everything in mind the best move would probably be to retest. Please could you arrange that for me? AH

jeremydpbland
Online

Booked - we will put a letter in today's outgoing post. JB

enna
Offline

Thank you so much. AH

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