Cyst on flexor tendon in wrist, moderate carpal tunnel, is surgery worth it?
I need some assistance and advice.
I started experienceing carpal tunnel symptoms after my first child was born over two years ago. The symptoms progressed over a year and resulted in triggering of my hand upon straightening it, numbness in certain wrist positions, and hand pain. A cyst soon was visible on the underside of my wrist attached to one of the flexor tendons.
Over the past year, I have returned to work, and the hand trigger and pain has disappeared, but still with residual numbness at night when not wearing a splint. The cyst in the wrist is still present, and I need to stretch the tendons in the morning to get my fingers to straighten. And I feel lumps on the tendon within the wrist.
An ultrasound of the cyst showed debris/something solid within it, and a nerve conduction study showed moderate carpal tunnel syndrome. My surgeon has proposed open carpal tunnel release surgery, then removal of the cyst if he can access it.
I am considering not going through with the surgery, because I am only in my 30s, and wish to have more kids. So I am worried that my wrist will never be the same after surgery due to possible complications with the cyst removal (nerve damage, tendon scarring, artery damage), and the fact that raising kids is always hard on the wrists.
My doctor tells me that if I don't get the surgery I risk permanent nerve damage and muscle wasting. But is this on the scale of another year or two? Or after 10 years? Also, will getting pregnant after having this kind of surgery pre-dispose me to other complications during the recovery period?
Lots of questions for sure. Any advice is appreciated. Thanks.
That's an interesting and unusual problem and I would not want to give any definitive advice without seeing the imaging and the nerve conduction results. However I think it is fair to say that the majority of patients who have carpal tunnel surgery do not suffer long-term ill-effects and in people who definitely have proven CTS there is little doubt that surgery offers the best overall chance of a permanent solution to the problem. I would therefore not worry unduly about carpal tunnel decompression on grounds of age or child rearing. There is probably at least as great a risk of long-term problems if you leave the CTS untreated and it gets worse. CTS can progress at any rate so it is not possible to predict how long it might take to deteriorate, or indeed whether it will deteriorate.
The cyst is much more diffficult as I cannot tell what it is - there are a variety of cystic and semi-solid 'things' that can manifest as a lump in the wrist and the outlook for treating them depends on what they are. In some cases it may not be possible to be sure what the thing is without taking it out.
Finally - I am not aware of pregnancy causing any particular problems after carpal tunnel surgery. I hope this helps. JB