Ask Your Carpal Surgery Doctor Questions
The most important ones to ask
Print to go over with your doctor next appt.
Are you having carpal tunnel surgery? If so, then the condition must be unbearable. And you have my sincere and deepest sympathy because I know the agony you’re going through.
My name is Dr. Zannakis (Dr. Z) and I’ve been advising patients on carpal tunnel for 15 years. Over the years, I’ve saved 1000s from surgery who found me on this very website – just like you!
I invented the Carpal Rx for my wife so she didn’t have to go through surgery.
Carpal Rx is the best kept secret in hand health.
97% of surgery patients who use the Carpal Rx are cured of their symptoms in 30 days. It’s 1/30th the cost of surgery out-of-pocket and there’s a 100% money-back guarantee. Think about trying it RISK FREE before going ahead with surgery.
Thanks for listening!
Now let’s help you prepare for your next Dr. appointment
Deciding on surgery is a last resort, and a major life event. Your decision tells me how severe your symptoms really are, and that you need help right now.
As much as I would like to, I cannot offer much comfort sitting here at my desk. But I might be able to offer some advice that needs addressing frankly and openly with the hand surgeon.
Allow me to say that ANY surgery is a major affair, and you must be your own advocate. The absolute best thing you can do for yourself is always ask your carpal surgery doctor questions. Most doctors will be happy to make you feel relaxed, and provide definitive, no nonsense answers that you clearly understand and are satisfied with.
Print these review points to go over with the surgeon at your next appointment. If you’re not satisfied with the answers or if your doctor will not take the time to review them with you, then find another doctor! (Honestly, there’s no shortage.)
Carpal tunnel surgery questions to ask
Make sure your doctor doesn’t guarantee a cure
The fact is that carpal tunnel syndrome is a disease that has no cure. Surgery is just one kind of “fix” that may last a few months or a few years…or it may not work at all. No surgery comes with a guaranteed, so don’t fool for thinking the outcome is written in stone.
Is your doctor certain the problem is carpal tunnel syndrome?
The NIH says that carpal tunnel syndrome is misdiagnosed almost 50% of the time. As a result, over 50% of carpal tunnel surgeries are unnecessarily performed. Other problems that look like carpal tunnel include:
These can imitate carpal tunnel symptoms, but they’re totally unrelated conditions – and usually don’t require surgery. Your doctor should determine if you have another illness that could be causing your symptoms. Be sure to ask your carpal surgery questions that are to the point.
Is your diagnosis based mostly on electro-diagnosis?
Electro-diagnosis of carpal tunnel syndrome is inaccurate, and the doctors’s physical exam must verify it. The physical exam includes specific tests for carpal tunnel (called provocative tests) and include the Tinel, Phalen, and Durkan tests. Ask your carpal surgery doctor questions about his or her opinion on electro-diagnosis. Be wary if your doctor calls it the “gold standard.”
Have you given non-surgical therapies a good try?
Both the NIH and the American Academy of Orthopedic Surgeons advise that you should only consider surgery if your symptoms have been severe for over 6 months AND you’ve tried all non-surgical therapies without success. These include bracing, exercise, massage, and steroid injections. Such non-surgical remedies are highly effective in 85% of patients.
Which surgical method will your doctor perform?
The surgery called “carpal tunnel release surgery” aims to cut a ligament inside the wrist. The doctor performs the surgery using one of two basic methods. The first is “open release carpal tunnel surgery” and the second is “endoscopic carpal tunnel surgery”. Open release surgery involves making a 2-3 inch long incision on your wrist and palm in order to cut the ligament. In contrast, endoscopic surgery uses an endoscope. Therefore the surgeon makes only one or two tiny incisions in the wrist and palm. (There are also two types of endoscopic surgery, called single portal or double portal). Each type of surgery has its advantages and disadvantages. Most surgeons have greater experience with open release surgery. Fewer surgeons perform endoscopic surgery.
Understand the differences and ask which you will have. A good doctor will have successfully performed thousands of that particular surgery.
Find out about preparing for carpal tunnel surgery here.
Discuss all of the risks and benefits of carpal tunnel surgery.
All surgical procedures have risks like permanent injury and even death. Common carpal tunnel surgery risks include excessive blood loss, nerve injury, reaction to anesthesia, prolonged healing, and excessive scar formation. It’s a good idea to ask your carpal surgery doctor questions on the most common risks he or she encounters. The answer may be a red flag.
What kind of anesthesia will you have?
You will either have a general or local (including nerve block) type of anesthetic. It all depends on the type of surgery you have. Discuss these options, and whether or not you will meet with an anesthesiologist in advance to discuss all allergies. Don’t be afraid to ask your carpal surgery doctor questions that he or she may find intimidating.
Make sure your surgeon operates on the right arm!
You’ve heard of the people who scheduled an appendix removal only to have a leg amputated. This is not urban legend but unfortunately happens every day. Request that the surgeon will pre-operatively confirm and mark the surgical site as you watch. Don’t be shy – ask your carpal tunnel surgery doctor questions that are provocative.
What is your doctor’s reasonable expectation of the surgery?
Remember that carpal tunnel syndrome is a disease with no cure. Symptoms may lessen after the surgery, at least for some time. But in 25-40% of patients, symptoms return within one year. What happens then; another operation?
What happens in the hours-to-days after your operation?
You will be in the recovery room immediately after the surgery. Your hand will likely feel numb from the anesthetic and it will have bandages. You will get discharge instructions about wound care and changing the dressing. You will come back in about 10 days to remove the stitches. Prescription and over the counter pain medications can manage post-operative pain.
I go into detail explaining what to expect after carpal tunnel surgery here.
What can you expect during your recovery period?
You should get an estimate of how long the recovery will take and what you can and cannot do in this time period. What limitations will I have? Will you need assistance at home? How much disability can you expect? Ask how extensive will the rehab and physical therapy be. Will you be able to return to work, and when? What about driving, will you be able to grasp a steering wheel? Can you have sexual activity?
Will you need to change jobs?
Symptoms of carpal tunnel syndrome will more likely return if you continue to do the same activities that caused the problem to begin with. Will you need to reduce or totally stop your job activities (which may require a lot of hand movements)? Approximately 25% of patients must find a different job after recovery.
Ask your carpal tunnel surgery doctor questions about rehab
Everybody must restore their hand and finger strength and mobility after this surgery. Rehab time can take up to a year to complete. Go over the rehab plan with the doctor right now so you’re not surprised. And be sure to ask about the cost: rehab is almost always NOT part of the surgery cost. It’s a good idea to ask your carpal surgery doctor questions about his or her financial relationship with the facility you’re referred to.
What will your carpal tunnel surgery results be a year from now?
After you and your doctor carefully discuss the risks and benefits of hand surgery, ask what the plan is in one year. If your hand is fine, then you’re gold – and hopefully symptoms won’t return. But what if the pain, numbness or tingling comes back the, or soon after? Surveys show that over 50%f of all surgical patients are not satisfied with their results one year later. So plan ahead in the event you don’t see good improvement.
Ask your carpal tunnel surgery doctor questions about experience
You must ask how many surgeries the surgeon has performed, and what their one year success rate is. Has the surgeon ever had problems with a surgery? Did their surgery ever resulted in damage to the patient? Patients usually are too embarrassed to ask these hard questions. After all, you assume the doctor is a professional and asking these questions might sound like you don’t trust their skills. Don’t assume anything because this is YOUR life. It’s better to find out how good they now than after your operation.
What can you do to improve recovery?
The surgeon will give you recommendations of do’s and don’ts for the weeks and months following the surgery. Aside from the obvious wound care and rehab directions, the doctor normally advises several days of rest until you can work up to routine exercising. Also, adjust your posture while seated to avoid straining your arms. You may also have to modify or curtail some job activities.
The NIH published a good carpal tunnel syndrome fact sheet.