Ergo Myths

Surgery Cures Carpal Tunnel Syndrome



Approximately one percent of the population gets surgical treatment for carpal tunnel syndrome (CTS), and in about one quarter of the cases, both hands are operated on. In the United States, there are approximately 400,000 carpal tunnel surgeries per year; it is among the most frequently performed operations in the U.S. Often, people who have had the surgery once will be treated with multiple subsequent surgeries. Although surgery may temporarily relieve some of the symptoms, it cannot cure the ailment.

To solve the problem, we must first understand the root cause. CTS is a repetitive strain injury that occurs when the median nerve is compressed at the wrist, leading to pain and muscle weakness. It is often associated with performing rapid, repetitive tasks and maintaining constrained postures. Although information about the risk factors is available, individuals often turn to surgery to relieve the pain. The common response from doctors when asked about carpal tunnel surgery is to “change your career and schedule surgery”; they understand that if patients do not appropriately address the root cause(s), CTS symptoms often return within a year or two of the surgery.

So what can we do to prevent carpal tunnel surgeries and ensure that no one must undergo multiple surgeries? Initially, many mild carpal tunnel syndrome sufferers change hand use patterns and postures at work or avoid hand activities to minimize pain, if possible. This does not mean switching mousing hands so that you end up with CTS in both hands; rather, take regular breaks from repetitive tasks. Or, change or rotate jobs to avoid the continued repetitive stress tasks. Also try adjusting the frequency of repetitive movements and increasing the number of rest periods between the movements.

The key to conservative CTS treatment is ergonomics. It is important to fit the job to the person, and not the person to the job. Having a properly designed workstation reduces the amount of effort required to maintain a proper working position. While the office setting is where CTS is most common, it is beginning to occur more often in industrial environments. Although the concepts of workstation design are similar in both settings, the guidelines differ significantly. The focus of CTS prevention should be on workstation improvements, as surgery alone will not change what people do or how they do it.