When we are hurting, we want the pain to go away but we don’t always make decisions that will move us in the direction toward wellness. We are afraid of going to the doctor, and our imaginations get the best of us when we conjure up all sorts of negative outcomes. When it comes to carpal tunnel syndrome (CTS), it might be helpful to understand how to predict the success of your treatment. Let’s talk about duration of symptoms vs. severity of symptoms:
Duration of symptoms
Duration of symptoms means how long you have had these symptoms. With CTS, your symptoms might be tingling or numbness in your thumb, first and second fingers, and the inner half of your ring finger. You might have tingling in your palm as well as trouble gripping or carrying bags with some weakness in the hand. Some people also experience pain in the wrist or even up to the elbow. If not addressed, these symptoms worsen. For example, you may only notice tingling or numbness at night at first. As your symptoms progress, your whole hand may feel numb. These symptoms indicate that the median nerve isn’t connecting with the muscles in your hand and fingers. By consulting with your physician early, you might alleviate your symptoms with noninvasive treatments, like splinting your wrist at night. However, sometimes noninvasive treatments are not enough to resolve CTS, and surgery is indicated.
Severity of symptoms
At first, CTS symptoms might seem livable. The tingling in the fingers and hand, while annoying, aren’t life-threatening, and you can quickly learn to compensate for having a weaker grip. However, over time the symptoms will become worse. This is because CTS is typically a progressive neuropathy, and this means that there are muscles in your hand which rely on input from the median nerve in order to function. Without that input due to the compression on the nerve, the muscles atrophy and waste away. If the median nerve is compressed for a long period of time, it can also sustain damage, and this damage cannot be reversed by surgical treatment.
Though you might think that having symptoms for a fairly long time could negatively affect your post-surgical recovery, studies show that how long you have had CTS symptoms will have no effect but the severity of your symptoms might. One study looked at data from both the US and the UK. Using information from 2 hand centers and looking at post-surgical results from 523 hands including patient self-assessments, researchers determined that duration of symptoms had no impact on CTS surgery outcomes. However, those patients whose symptoms were more severe still had some symptoms even 6 months after surgery.
Another study from the Netherlands reported similar results. Researchers studied over 1000 patients who had CTS surgery between 2011 and 2015. These patients completed self-assessment questionnaires before surgery, and then again at 3 months and 6 months post-surgery. This study concluded that “clinical severity of carpal tunnel syndrome at intake is the most important factor in estimating symptom relief after surgical treatment,” and that by understanding this, patients can manage their expectations about their post-surgical results.
Surgery for CTS is successful in treating its symptoms most of the time, but these studies show that patients need to understand that the severity of their symptoms (not the duration) may mean that they won’t be completely symptom-free post-surgery. Doctorpedia is here to support and encourage all CTS patients to talk to their doctor about treatment options. While we can’t predict the future, we can offer information to assist you in managing your expectations for treatment of CTS.
- Burke, F.D., Wilgis, E.F., Dubin, N.H., Bradley, M.J., & Sinha, S. (2006). Relationship between the duration and severity of symptoms and the outcome of carpal tunnel surgery. Journal of Hand Surgery 31(9), 1478-82. Retrieved from https://www.jhandsurg.org/article/S0363-5023(06)00973-7/fulltext
- Carpal tunnel syndrome. (2017). Medline Plus. Retrieved from https://medlineplus.gov/ency/article/000433.htm
- Jansen, M.C., Evers, S., Slijper, H.P., deHaas, K.P., Smit, X., Hovius, S.E., & Selles, R.W. (2018). Predicting clinical outcome after surgical treatment in patients with carpal tunnel syndrome. Journal of Hand Surgery 43(12), 1098-1106. Retrieved from https://www.jhandsurg.org/article/S0363-5023(18)30650-6/fulltext
- Kakar, S. & Bishop, S. (2012). Left untreated, carpal tunnel syndrome can lead to weakness in fingers and thumb. Mayo Clinic. Retrieved from https://newsnetwork.mayoclinic.org/discussion/left-untreated-carpal-tunnel-syndrome-can-lead-to-weakness-in-fingers-and-thumb/