Carpal Tunnel Surgery--residual nerve damage

[Silent all these years]

I have had carpal tunnel syndrome in both hands, more severe in my dominant right hand. I have investigated surgery several times but each time I approached doing it my life would change and along with that change would be an inusrance change so I would have to start over with a new doctor.
     So now I am scheduled to have surgery on my left hand. Since I have had this condition for many years and my fingers are now numb all the time with some wasting of the thenar emminence, is it possible that I have waited too long and I am not going to get return of sensation after the surgery? What are the chances?

[CCF Neuro[P] MD, RPS]

Dear JB:

Unfortunately, I cannot tell you what the outcome of surgery is going to be, whether you have waited too long for any meaningful recovery.  I would hope that your neurologist has explained the possibilities to you.  I haven't seen the EMG reports, done the examination, nor followed your case.  Since you have some muscle wasting, the process has been going on for some time.  Surgery will help, but how much it difficult to say. It is safe to say that your symptoms will get better, however.  Alot depends on how many nerves have died, the EMG report will help alot and your neurologist will be able to give you some estimate of recovery.

Sincerely,

CCF Neuro MD

[Dee]

I didn't know you could wait to long to get the carpal tunnel fixed.  Is it always a progressive thing?
I have had carpal tunnel symptoms for many years.  Sometimes it is just a minor inconvenience, other times it is quite severe, with pain shooting all the way past the elbow and severe enough to wake me up at night crying.
Since it comes and goes, I just put up with it.  When it is bad, I increase my use of wrist braces.  A prednisone taper usually helps when things get too bad; I end up on prednisone tapers several times a year for asthma and also for symptoms related to my connective tissue disease; invariably I get relief from the carpal tunnel at the same time.
As long as the course is variable, and even though it gets very bad it sometimes gets better as well, does that mean no damage is being done.
I am hypothyroid too since 1984; I have been told it can be related to the thyroid condition, or to the connective tissue disease, or to repetitive stress....I have all three conditions.
Is there a need for evaluation even though I know no matter how bad it gets it eventually gets better?
Should the evaluation be done only when there are symptoms, or would something show up all the time?
Dee

[CCF Neuro[P] MD, RPS]

Dear Dee:

There are certain criteria that we use when we think surgery is needed.  Muscle atrophy is one of them, symptoms that make the patient really miserable, and on EMG when slowing reaches a certain value.  I would see a neurologist and see if you need surgery or not.

Sincerely,

CCF Neuro MD