Carpal Tunnel Syndrome (CTS) is the most common nerve compression issue in the upper extremity. But when it comes to treating it surgically, many people hesitate—but why?

In a recent stud, Gong et al. uncovered exactly what influences patients' decisions to undergo (or avoid) carpal tunnel release surgery. And the findings might surprise you.

• Symptom severity is the top reason patients choose surgery
• Symptom improvement during the waiting period is the biggest reason for canceling surgery
• Fear of temporary weakness and financial stress are major deterrents

What Is Carpal Tunnel Syndrome (CTS)?

CTS occurs when the median nerve—which runs through the wrist's carpal tunnel—gets compressed. This compression causes tingling, numbness, and pain, especially at night or while using the hands. It can progress to muscle weakness if untreated.

Common treatments include:

• Wrist splinting
• Anti-inflammatory medicatons
• Steroid injections
• Surgery (carpal tunnel release)

Why Patients Do (or Don’t) Choose Surgery

• Top 3 Reasons Patients Chose Surgery:
  • Severe symptoms (e.g. tingling, pain, weakness)
  • Failure of conservative treatments (e.g. splints, meds)
  • Fear of symptoms getting worse
• Top 3 Reasons Patients Canceled Surgery:
  • Symptoms improved during the wait
  • Fear of surgery
  • Lack of support at home

Patient Fears: It’s Not Just the Scar

Patients who avoided surgery had higher anxiety about:

• Temporary hand weakness
• Financial burden
• Pillar/scar pain
• Inability to care for home or family

Real-World Function: Surgery vs No Surgery

Both groups (those who had surgery and those who didn’t) showed significant improvement in symptoms and function after approximately 30 months.

What This Means for You: Should You Get Surgery?

Ask yourself:

• Are my symptoms disrupting daily life or sleep?
• Have I tried conservative treatments for at least 2 months?
• Am I seeing no improvement or even worsening symptoms?
• Do I have concerns about cost, recovery, or family care?

Final Thoughts

Surgery can be life-changing for many with carpal tunnel syndrome. But it’s not a one-size-fits-all solution.

• If your symptoms are unbearable and conservative treatments fail, surgery is a strong option.
• If you're improving or hesitant due to costs or recovery concerns, it's okay to wait and monitor.

The best decision is one made with your doctor, based on your unique situation—and with your own quality of life at the center.

References:

Gong HS, Baek GH, Oh JH, Lee YH, Jeon SH, Chung MS. Factors affecting willingness to undergo carpal tunnel release. J Bone Joint Surg Am. 2009 Sep;91(9):2130-6.