Treatment options for Carpal Tunnel

[Fuzzymum1]

I had nerve conduction studies done at the hospital last week and got to see the consultant briefly while I was there. She confirmed that I have mild CTS on the left and worse on the right. She said that my GP may offer me the option to have surgery on my right wrist though he has previously suggested we would try steroid injections first before going straight to surgery.

Anyone had experience of steroid jabs or surgery? I want to be able to make an informed choice when I see him next week (assuming the hospital have sent the results by then) I'm not squeamish and needles surgery don't bother me but I'm not sure I fancy either option particularly but need to do something as it's causing issues with all sorts of things. I have a degree of arthritis too if that makes any difference.

Any recommendations? Is it worth trying steroids before surgery? I've had symptoms for around a year so it doesn't look like it's going to resolve by itself.

No advice (sorry) but am in a similar position so watching with interest

I had traumatic carpal tunnel syndrome (getting great big 60kg calf out of little heifer uterus at c-section). Due to the fact that I'm the boss and I was going to need more than 2 weeks off after surgery due to nature of job I had the steroid as a holding pattern before surgery. Mine was so severe I was unable to place intravenous cannulas due to weakness.
Steroid injection no pain day of injection the next 48 hours were complete hell worse than the 48 hours post surgery I could not use my hand in any shape of form due to terrible pain and weakness. Then steroid kicked in it lasted exactly 28 days and the CTS returned exactly the same.
Surgery is under local very weird as you can feel, but it doesn't hurt. First 48 hours a bit sore, but could drive after 5 days (left hand automatic car). As I say I needed 3 weeks off due to nature of job. I was very careful kept stitches dressed still stitches out and used rectal gloves to keep dry in shower. I had no stitch infection which I know a lot of people do get, but I think was due to my paranoia care of the wound. It took me 6 months for my full fine surgical dexterity to return. 9 months after surgery it is fantastic. I did use my hand well after surgery and had very good movement at 3 week Physio I have continued to do my physio for 6 months and was told I should keep doing it for a year.
I saw a specialist hand surgeon, I am really lucky one of the top 4 in country is local to me and as he said this is his day job and he is where everyone else's surgical failures go so his failure rate is very, very low. I do know other people who have had theirs done by general ortho or general neuro and the outcome and follow up has not been so good. I did do my research and made sure I was referred to the right man as I can not afford to have repeat surgery.

Thanks for that, it sounds like the steroids will do nothing but delay the need for surgery. It's good to hear first hand experiences, especially as you have had both types of treatment. I had heard the steroids can be nasty for a short while before and it's useful to have that information, thanks. Thankfully I have a very helpful hubby and two capable and willing teenagers who between them can do everything that needs doing at home for a while and have been very willing assistants when I'm struggling to open jars etc.

Have you had your thyroid checked? It can cause carpal tunnel.

Yes, the first thing the doctor checked was my thyroid, I don't remember the numbers but it was fine.

Who did you see, lonecat?

I had my carpal tunnel operated on about 18 months ago and would second most of what Lonecat said. I also found the steroid injection absolutely the most painful bit and had no benefit from it, although that might be because it was pretty bad before I did anything about it.
It is a simple operation and so I wouldn't get too hung up on who does it, providing that the surgeon does a reasonable number a year. In any case, unless you are paying privately your operation might well be carried out by the registrar or below, under supervision.
Evidence shows that it is best carried out fairly early, before muscle wasting occurs. I am a physio, so also depend heavily on my hands for work and I found it was about 6 months before it was back to normal. Definitely worth having done though!

My neighbour was offered a steroid injection for hers, as she was told that can sometimes cure the problem. It didn't work. They did another one. That didn't work. They eventually operated but because they'd delayed matters so long (which I really think is a money-saving strategy, rather than best practice) that the nerves that had been compressed have been permanently damaged and 2 of her fingertips are totally numb. The op is a very simple one and if I had carpal tunnel I wouldn't want to go down the steroid route first.

Sauvignon I had my surgery done by Mr Hobby.

I had steroid injections which were pretty horrible (big thick needle etc) but helped a lot for a few months. My CPS eventually resolved itself because it was due to pregnancy/breast feeding.

I have had steroid injections in both hands. Right (dominant) hand was worse. Lasted 4 months then CT returned. Had a second injection which is still working 2 months on. Left hand hasn't needed repeating (yet?).

I'm not that keen to have unnecessary surgery and the jabs are painful but not that painful (mostly better and can drive next day) so at the moment feel I' rather have 3-4 injections a year than surgery. If they needed to be more frequent I'd have the surgery - and actually suspect doctors won't keep giving them to me indefinitely.

That's all really useful thanks. I might push for surgery, I've had symptoms for a year or so but other than some generalised arm pain the symptoms aren't there all the time - the numbness comes and goes so hopefully surgery would have a good outcome.

A little update:

I decided to go with the steroid injection in my right wrist as a 'first line of defense. I had the injection this morning and it wasn't as bad as I expected but on and off through the day my hand and wrist have been throbbing. Some GPs inject a local anaesthetic with the steroid apparently but my GP doesn't.

Hopefully it will improve for the next couple of days :D

Thanks for the update! How is it now?

I had the anaesthetic jab the first time but chose not to the second time and was fine without.