Generally, if we tried conservative measures (such as splinting and a cortisone injection and maybe some anti-inflammatories) I see the patient back a month later to see how they’re doing. Usually within a month you’ll know if the symptoms are going to improve with activity modification, splint immobilization, and a cortisone injection. Generally if after a month the patient’s symptoms are the same or worse, then I would order a nerve study to assess the severity of the carpal tunnel syndrome and if it’s moderate or severe, I would suggest surgery. If it’s mild, if they wanted to try a course of additional non-operative management, then I think that would be very reasonable.
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