CTS symptoms for about 8 months now ...


Hi, I am female aged 54

I went to my doctor back in Feb 2013 to discuss tingling/burning/numbness that for about 6 months I had been having in both wrists and hands (far worse on right). I put off seeing doctor in the hope that it might wear off and disappear by itself.

The doctor sent me to hospital for Nerve Conduction testing.

Went back to doctor for results - it was confirmed (as I had already stated) that I have CTS in both hands but worse on the right. I asked to be referred for surgery (preferably keyhole) but the doctor advised that it was the practice policy to try the injections first.

When I got home I 'googled' all about the injections as my interpretation of the online information was : ...
a) that for some people it helped a bit
b) that for most people it was simply a time delay of perhaps one month's slight improvement before many then went on to have the surgery anyway
c) that there are many scare stories where the injections went badly wrong i.e. injection went into the nerve/muscle etc, and various side effects like searing pain up the thumb that remained for months, hand going grey and remaining cold, sometimes finger ends went black and had to be amputated

etc !!

I contacted my doctor and explained that I simply would not be prepared to take the risk of injections but wished to opt for surgery PLEASE

The doctor put my case forward at their practice meeting, and then forward to the hospital.
Having called the doctor's surgery this morning I have been advised that the next I should hear is a surgery appointment date from the hospital.

I did look on the internet at various alternatives to surgery i.e. CTRAC, also there are some kind of hand plasters, worn at night, that stick around from the back of your hand onto three areas close to the carpal tunnel (I suppose to attempt to stretch the tunnel), but for me surgery is my choice - ideally keyhole.

The numbness and tingling and sometimes unbearable pain occurs at any time during the day and night and wakes me up and it hurts so much it makes me cry. No amount of hand shaking, clapping etc alleviates it.

I just want to have the surgery and get on with life.


I think it is interesting that the impression a patient gets from a google search can be some way off reality - sorry!

I think what you have to bear in mind is that surgery is by no means guaranteed to fix the problem. It is easy to get fixated on horror stories following injection but there are in fact many more horror stories following surgery and your posting shows no sign that you have appreciated the risks that go with operation. We find that about 1 out of every 20 patients having surgery regrets having had it done compared to only one out of every 1000 injections (in round numbers). I see someone who is dissatisfied with the result of surgery once or twice a week..... and someone who has a problem from steroid injection about once every year or two - and more injections than operations are done around here.

It is true that the improvement after injection is usually temporary but you have to balance the risks and benefits - patients who are significantly disabled after carpal tunnel surgery are usually permanently left in that state.

So, for your a-c these are the actual figures, so far as possible....

a) "some people helped a bit" - 80% of people experience a similar degree of relief to that offered by surgery - ie completely cured or so much improved that residual symptoms are not a signifcant problem

b) 'most' a delay of '1 month' and 'slight' improvement - the same figures - our initial follow-up is done at 6 weeks and 4 out of 5 patients report themselves satisfied with the outcome of injection - so by that point I think one has to say that 'most' ie 80% actually have substantial relief of symptoms lasting at least 6 weeks. In fact we find that about half of those patients are still perfectly OK a year later and some for much longer.

c) There are quite a few scare stories around but documented cases of problems in the literature are surprisingly rare when you look for them. I can find 12 reports of injection into a nerve, 3 cases of tendon rupture and 4 cases of gangrene of a fingertip...... out of many millions of injections given worldwide for CTS - again when you compare with the number of patients with permanent problems after surgery it all looks a bit different.

C-Trac and the 'carpal soution' have not been shown to have any effect on CTS in good quality randomised trials and should be considered unproven.

Keyhole surgery is fine if you can find a surgeon who is already experienced with it and gets good results - the challenge is in finding a surgeon like that. The actual results of keyhole surgery are very similar to those of open surgery except for a slightly faster recovery time.

It's interesting that they have told you that you will be listed for surgery directly based on the GP's say-so and the nerve conduction results. In most areas of the UK at least the hand surgeons are more likely to see you in out-patients first to decide on surgery but there are a few one-stop clinics around where they may operate the same day.

My own view is that there are circumstances when surgery is more appropriate and circumstances when non-surgical treatment with a combination of splint and steroids is a better choice. I don't know what I would recommend for you because I don't know enough about the case. Neither treatment option should be purely a matter of 'policy' nor should decisions be based on inaccurate information from the web or anecdotes from friends and neighbours. Patients should ideally be helped to make their own decision armed with the most accurate information available about the pros and cons of each option. That is one of the main purposes of this website, as it contains far more detail regarding these issues than anything else on the net (at least that I have been able to find).

If it is disturbing your sleep that much at night have you tried getting hold of splints as a 'first aid' measure while waiting for operation? - they are sometimes surprisingly effective at controlling night-time symptoms. I hope that they are fairly quick with surgery for you and that it is successful. JB

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