Next Gen Carpal Tunnel Care
“Tell me about your symptoms &
I’ll evaluate them for you”
Ask your carpal surgery doctor questions
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 carpal tunnel doctor. Ask your carpal surgery doctor questions that you feel are foremost in your mind. I can help you formulate them here.
First, allow me to say that ANY surgery is a major affair. Hence, 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.
Now let’s help you prepare for your next doctor appointment.
Make sure your doctor doesn’t guarantee a cure
As you learn about carpal tunnel syndrome you come to understand it’s 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.
Carpal surgery doctor questions to ask about your diagnosis
Electrodiagnosis of carpal tunnel syndrome is inaccurate. Thus, the doctor’s physical exam must verify the diagnosis. Ask if the physical exam formed the primary diagnosis. The physical exam includes specific tests for carpal tunnel (called provocative tests). They include the Tinel, Phalen, and Durkan tests. Adk if these were done. Finally, ask your carpal surgery doctor questions about his or her opinion of electrodiagnosis. Be wary if the doctor calls it the “gold standard.” That means they are not abreast of the latest scientific data (as of 2019).
Have you given non-surgical therapies a good try?
Both the NIH and the American Academy of Orthopedic Surgeons guide doctors’ decisions. They say that patients should only consider surgery if symptoms are severe for over 6 months. In addition, patients must try all non-surgical therapies first. For instance, these include bracing, exercise, massage, and steroid injections. In fact, 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 more about carpal tunnel surgery preparation.
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 pre-operatively confirms and marks 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. Then, you will come back in about 10 days to remove the stitches. Prescription and over the counter pain medications can manage postoperative pain.
I go into detail explaining what to expect after carpal tunnel surgery here.
Ask your carpal tunnel surgery doctor questions about recovery
First, get an estimate of how long the recovery period will take. Second, ask what you can and cannot do in this time period. What limitations are there? 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 publishes a good carpal tunnel syndrome fact sheet.
The idea of having hand surgery can be scary. But if you know what will happen and what you can expect, then it’s not such a frightening prospect. Make sure to discuss all issues you have with your doctor. Remember, don’t fear the “dumb questions” because there are none. Probe hard and get frank and honest answers from your doctor. Finally, listen to your inner voice. If you don’t feel comfortable, then find another doctor. Your hand’s future is at stake!
Two 15 minute Carpal Rx treatments for 30 days cures symptoms in 97% of carpal tunnel patients.
I’m asked many questions every day about hand surgery. Please know that there are no dumb questions. Surgery is a serious step in your life, so approach it wisely. Also, make sure you actually need surgery. Several health organizations warn that the majority of carpal tunnel surgeries are unnecessary. That’s because there are many good non-surgical remedies available. And that’s why I invented the Carpal Rx. It exactly duplicates a physical therapist’s myofascial massage to relieve carpal tunnel symptoms. But now you can have it in the comfort of your home. Just two 15 minute treatments a day for 30 days cures symptoms in 97% of patients.
Good luck with whatever you decide to do. Remember, we’re here for you. Call us up and pick our brains!