Should I postpone an operation if I am not in pain?
Dear Dr Bland,
I hope you had a restful festive season. All the best for 2013!
I had a 3rd injection in my right wrist in October 2012 after having experienced a great deal of pain in both right wrist and arm. Whilst the 2nd injection (carried out in July 2012) did not help for more than a couple weeks, this last injection seems to have worked and I have had absolutely no pain since it was done. I have only experienced a little numbness during a few nights but I think that has been more from sleeping on my right hand than anything else.
I am booked in for an operation on 16th February 2013 and my question is whether I should postpone the operation as I am currently experiencing no pain.
Thank you as always for your advice and help.
Kind regards,
Anna Strzeminska-Bowden
Thank you for your reply, Doctor. I think I may have jinxed my wrist by writing to you as I have had quite a bit of pain the last couple of nights! The wrist is better today as I had a chance to rest it over the weekend, but I have decided to go through with the operation (which is scheduled in for 16th February) rather than wait for things to get worse. Thank you again for your advice and help. Kind regards, Anna Strzeminska-Bowden
I'm glad we've reached a decision. Fortunately, in dealing with CTS, it is usually possible to defer making irrevocable decisions like whether to operate, and also possible to change one's mind at the last moment so to some extent we do have the luxury of being indecisive about things. In this case I think it is not unreasonable to proceed with surgery. JB
That's always a tricky decision and there is no simple right answer. I think my inclination is generally to defer surgery if there are no significant symptoms and the nerve conduction studies were not too advanced (yours were grade 3 right and grade 1 left so not too bad). However a lot depends on your attitude as well. You have to balance the small risk that goes along with surgery against the prospect of likely further relapses in the future. I can give you the surgical figures fairly accurately but we have no adequate actuarial data to predict what the likely length of your current remission will be after three injections so there is a big unknown to take into account. If you find the prospect of having to deal with further relapses in the future bothers you a lot then go ahead with surgery as a preventive measure, otherwise sit tight and see how long it goes this time - you can come back to me anytime for further intervention. Sorry not to be able to offer clear guidance but we really do not know the answer to this one. JB