6 Myths and Truths About Carpal Tunnel Syndrome

Since carpal tunnel syndrome is a common condition, many people have some familiarity with this cause of hand pain, tingling, and numbness. This familiarity also leads to a fair amount of misinformation circulating as well.

Myth: Any hand pain or tingling is a sign of carpal tunnel syndrome, especially if you use a computer all day.

At the first sign of pain, numbness, or tingling in the hand or wrist, people may assume it’s a sign of carpal tunnel syndrome—especially if they sit at a computer for most of the day. Just as with any repetitive motion that’s done for long periods of time, typing on a keyboard or using a computer mouse all day can cause aches and stiffness in the hands and wrists. But this isn’t necessarily carpal tunnel syndrome.

See Is My Hand and Wrist Pain Caused by Carpal Tunnel Syndrome or Something Else?

Carpal tunnel syndrome has specific symptoms that set it apart from other conditions that can cause pain and numbness in the hand. For example, carpal tunnel syndrome typically causes tingling and numbness in the thumb, index, and middle fingers, but not the ring or pinky fingers. Also, the pain of carpal tunnel syndrome is usually worse at night.

See Distinctive Carpal Tunnel Syndrome Symptoms

Myth: Only people who work in a factory or type all day get carpal tunnel syndrome.

Work-related conditions that involve high levels of hand-arm vibration or hand force, prolonged work with a flexed or extended wrist, or high repetitiveness are associated with a higher risk for carpal tunnel syndrome, according to one systemic review of studies. ¹ Van rijn RM, Huisstede BM, Koes BW, Burdorf A. Associations between work-related factors and the carpal tunnel syndrome--a systematic review. Scand J Work Environ Health. 2009;35(1):19-36.

See Causes and Risk Factors for Carpal Tunnel Syndrome

However, there is no clinical evidence that work-related factors can cause carpal tunnel syndrome. Experts believe that work-related stress may be the “final straw” for individuals who have other non-behavioral risk factors, such as female sex, advanced age, or a history of diabetes.

Myth: The only way to relieve carpal tunnel pain is surgery.

Once carpal tunnel syndrome has been diagnosed, surgery is not the only tool to relieve the pain. There are several nonsurgical treatment options that can bring relief for individuals who want to postpone or avoid surgery:

• Resting the wrist by avoiding repetitive motion or heavy use
• Wearing a wrist brace
• Using ice therapy
• Taking NSAIDs or diuretics
• Taking an oral corticosteroid such as prednisone
• Receiving steroid injections

See Treatment Options for Carpal Tunnel Syndrome

If there’s a severe case of carpal tunnel syndrome that involves muscle wasting or potentially permanent damage to the median nerve, then surgery is advised as soon as possible.

Myth: Surgery for carpal tunnel syndrome is often unsuccessful.

The surgery for carpal tunnel syndrome, known as carpal tunnel release, is a common and largely successful procedure. Studies suggest it has a clinical success rate of 75 to 90%. Although it requires several weeks and physical therapy to restore grip strength, most patients experience a full recovery, with symptoms resolved and function restored.

See All About Carpal Tunnel Release Surgery

A revision surgery for carpal tunnel release can be performed if needed, but these are rare. One retrospective study of 2,163 patients who had undergone carpal tunnel release a decade earlier found that 3.7% had undergone a revision surgery. ² Louie D, Earp B, Blazar P. Long-term outcomes of carpal tunnel release: a critical review of the literature. Hand (N Y). 2012;7(3):242-6.

Myth: Getting carpal tunnel surgery means missing work for a long time.

Many people are hesitant to consider carpal tunnel release because they fear losing use of their hand for weeks or even months, or they don’t feel they can take enough time off work. But the recovery period for carpal tunnel release can be relatively quick—light non-repetitive use of the hand is permitted after about a week, when the bandage is removed.

In fact, those who have jobs with minimal involvement of the affected hand may return to work in a week or two. This may be particularly true for those who receive the endoscopic approach. A splint may still be needed occasionally to support the wrist, especially at night.

See Surgery for Carpal Tunnel Syndrome

Patients who had the procedure in their dominant hand or who perform repetitive labor, such as an assembly line worker, may need to wait six to eight weeks before returning to work. After two or three months, most patients will experience the return of grip and pinch strength and can resume heavy use of the hand.

Myth: Endoscopic approach is riskier than open approach.

In the past, many patients were concerned or advised against the endoscopic approach for fear of higher risk for complications such as nerve damage.

However, current research shows that there’s no statistically significant added risk of complications from the endoscopic approach. A large systemic review of 28 studies that compared open and endoscopic approach for carpal tunnel release found that: ³ Vasiliadis HS, Georgoulas P, Shrier I, Salanti G, Scholten RJ. Endoscopic release for carpal tunnel syndrome. Cochrane Database Syst Rev. 2014;(1):CD008265.

• Both approaches were equally effective in relieving symptoms and improving function and had similarly low rates of major complications
• The endoscopic approach was better in restoring grip strength, allowed patients to return to work faster (by eight days on average), and was safer in terms of minor complications

Individuals who suspect they may have carpal tunnel syndrome—or have been diagnosed but have questions about their treatment—should see their physician to formulate a successful treatment plan.

See Diagnosing Carpal Tunnel Syndrome