Cortizone vs Surgery?

There are three parts to that question really:

a) How likely is it that there will be a response?

b) How much will the symptoms improve?

c) How long will the effect last?

Provided an adequate dose of steroid is used the answer to a) is that surgery and injection are about equivalent in ordinary practice with about 4 out of 5 people declaring themselves either completely cured or at least much improved so that any residual symptoms are not worth treating. Very expert surgeons who choose their patients well can get better initial success rates than that - but of course you have to be one of the patients who they think is a good bet for surgery.

If you measure the change in subjective symptoms with something like the Boston carpal tunnel questionnaire which we use, then surgery produces, on average, a somewhat larger improvement in the symptom severity score, so it might be considered a more 'powerful' treatment... but more powerful treatments tend to have more side effects and this is true of surgery vs steroid injection too - the complication rates are much higher with surgery.

for c) Surgery is the clear winner. The effect is, on average, much longer lasting - but recurrences do occur with surgery, sometimes after 10-20 years. After injection, about half of the patients relapse within a year. JB

I got the cortisone shots in both wrists. They wore off after 4 weeks and cost $400. I ended up just getting the surgery.

Thanks for the follow-up. Do you happen to know what dose and steroid they used? The cost is a good illustration of US healthcare costs. We reckon tha actual cost in staff time and materials is about $12. JB

I don't recall, sorry.