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Too Old for Carpal Tunnel Surgery? No Such Thing


"For patients with very slight symptoms, there should be no hurry to get an operation," Todnem says. "They can wait and see, and when the pressure around the median nerve decreases, the situation will normalize. Some patients will get better."

In the meantime, the best advice for those patients is to work less with the hands, Todnem says.

Stan Pelofsky, MD, president elect of the American Association of Neurological Surgeons (AANS), who was not involved in the study, says it demonstrates that age alone should not be a reason for foregoing surgery.

In the past, surgeons have been reluctant to operate on older patients for fear of complications resulting from other medical conditions, or from putting the person to sleep. But today, the surgery can be done safely and easily with a local anesthetic, which leaves the patient awake, he says.

Pelofsky notes that some patients in the study did appear to improve despite receiving no treatment, and that more conservative therapies -- such as splints, steroids, and decreasing work with hands -- can help some patients.

But many patients live with carpal tunnel syndrome for many years, he says, at significant cost to their quality of life. While surgery should not be the first option, it can be an alternative -- no matter how old the patient is.

If a patient has symptoms, a diagnosis of carpal tunnel syndrome, and conservative therapies haven't worked, "surgery is an excellent option, even if the patient is 80 years old," Pelofsky tells WebMD.

The incidence of carpal tunnel syndrome appears to be on the rise, though exact figures are hard to come by. One British study from 1998 found that 7% to 16% of patients experience carpal tunnel syndrome, with people over age 54 at higher risk than younger adults.

According to the AANS, carpal tunnel syndrome can be caused by any repetitive motions that cause swelling, thickening, or irritation of the membranes around the tendons in the carpal tunnel of the hands. These include repetitive and forceful grasping of the hands, and consistent bending of the wrist.

Other causes include broken or dislocated bones in the wrist, arthritis, thyroid gland imbalance, diabetes, and hormonal changes associated with pregnancy. In some cases, no cause is found, according to the AANS.



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