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    A Light at the End of the Carpal Tunnel


    "The surgery is a very minor procedure and the results are usually spectacular. If you don't get a good result from surgery, then the diagnosis may have been wrong, or else the patient waited too long, and nerve damage has already occurred," says Jeffrey Malka, MD, associate professor at Georgetown University and chairman of the department of orthopaedic surgery at Inova Fairfax Hospital in Falls Church, Va.

    "But carpal tunnel is very variable and you can't lump all cases together," Malka says. "You have to take into account the specific patient and what the symptoms are. You want to do the least you can do to benefit the person in the best way." Malka reviewed the study for WebMD.

    "Surgical treatment is superior to any other treatment, across the board. But if a person has only minimal symptoms, they may be able to avoid it, or at least delay surgery," says Gregory Hanker, MD. "If they have moderate to severe symptoms, the vast majority of people who get [conservative treatment] will worsen over time. Those people almost always need surgery." Hanker, who also reviewed the study for WebMD, is a hand surgeon and assistant clinical professor at the University of Southern California.

    Hanker says the recurrence rate is low following surgery, but, most important, patients need to be educated about the nature of disease. "You want to educate them how to lessen stress on their hands. Basically, it's common sense. Avoid those things that hurt, do those things that don't."

    This study was sponsored by the Navy's Chief Bureau of Medicine and Surgery.

    Vital Information:

    • The idea that carpal tunnel syndrome is a permanent disability that cannot be reversed may be a myth, according to a new study.
    • Most carpal tunnel patients who are treated are able to return to their jobs and resume a normal work capacity, even if modifications are necessary.
    • Those who undergo a surgical procedure are more likely to have their symptoms resolved compared to those who undergo other treatments, and the recurrence rate is low.
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