Treatments Options For Carpal Tunnel Syndrome

If the CTS is diagnosed in time and the early stages, it is possible to use non-surgical methods to help improve and manage the symptoms of this condition. 

Some of the non-surgical ways that Carpal Tunnel Syndrome can be treated include: 

Wrist Splinting

The injured worker can relieve nighttime symptoms of CTS, such as numbness and tingling, with the help of a wrist splint. Even if they use the splint only at night, it can help manage daytime CTS symptoms, too.

Non-steroidal anti-inflammatory Drugs (NSAIDs)

NSAIDs, such as ibuprofen, can help in relieving the pain from CTS. However, no evidence exists that these drugs help improve Carpal Tunnel Syndrome.

Corticosteroids

Your company’s healthcare provider might recommend corticosteroid injections for the injured worker. This is where a corticosteroid, such as cortisone, is injected into the carpal tunnel to relieve some of the pain. Corticosteroids help decrease swelling and inflammation, reducing the pressure exerted on the carpal tunnel.

Physical Therapy

Occupational or physical therapy can help strengthen and stretch the muscles in the hand and wrist with targeted exercises. This can help in managing and relieving the symptoms of work-related CTS.

Job Modification

As an employer, you can consider modifying the injured worker’s job tasks to reduce the frequency or intensity of their repetitive hand movements. This method can also help reduce the strain on specific muscle groups through workload distribution.

Weight Management

Workplace wellness programs that address weight management can help reduce the risk of CTS.

When is Surgery Needed for Carpal Tunnel Syndrome?

Surgery for work-related CTS becomes an option when non-surgical treatments fail to provide relief and symptoms are severe or persistent. An occupational healthcare provider may recommend surgery for CTS if there is evidence of nerve damage or if the condition impacts daily activities and quality of life. 

Below are some of the scenarios of CTS where surgery might be needed for work-related Carpal Tunnel Syndrome. 

• If persistent symptoms of CTS refuse to alleviate despite all non-surgical treatments
• If CTS significantly affects hand and wrist coordination, strength, and daily activities, leading to functional impairment. 
• If nerve conduction studies indicate significant nerve compression and potential damage to the median nerve
• If there is a risk of permanent nerve damage due to compression of the median nerve
• If the injured worker does not respond well to conservative treatments
• If the nighttime symptoms of CTS are severe and impacting sleep quality
• If individuals are working in occupations that involve long-term disability due to CTS

Surgical Procedures Used to Treat Carpal Tunnel Syndrome

Endoscopic Surgery

This is a minimally invasive surgical technique in which the doctor uses a telescope-like device with an endoscope (a tiny camera) attached at the end to view the carpal tunnel. This endoscope is used to guide the release of the transverse carpal ligament through one or two incisions with the help of specialized equipment. 

Endoscopic surgery results in minimal pain, reduced scarring, smaller incisions, and faster recovery time compared to open surgery. 

Open Surgery

Open surgery is a more traditional approach to treating Carpal Tunnel Syndrome. It involves making an incision into the palm and cutting through the ligament to free the nerve. This helps create more space and reduce pressure on the median nerve. 

This method allows surgeons to visualize the carpal tunnel directly. The recovery time may be longer than with an endoscopic surgery due to the large incision.

Risks & Post-Surgery Healing

It is recommended to discuss the risks and benefits of each technique with the surgeon before the procedure. As with all surgeries, the surgical procedure to treat CTS also carries risks, such as: 

• Potential injuries to blood vessels or nerves
• Wound infections
• Scar formations
• An incomplete release of the ligament

The healthcare provider will only recommend using the hand and wrist once the ligament has healed completely. The affected individual should gradually work back to normal use of their hand, avoiding extreme wrist positions or forceful hand motions in the early stages of recovery.