Predicting Outcomes for Carpal Tunnel Surgery

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May 7, 2022

Lately, there have been a number of articles published on research relating to anxiety caused by untreated carpal tunnel syndrome. It would be nice to be able to predict accurately how each person is going to react to the treatment, i.e., no pain vs. lots of pain, and how quickly their discomfort with any procedure is going to resolve.  Jansen, et al., from the Expert Clinic in Rotterdam, the Netherlands, in ASSH in 2018, “Predicting Clinical Outcome After Surgical Treatment in Patients with Carpal Tunnel Syndrome,” showed that the more severe the symptoms a patient had at the beginning of treatment, the greater relief they would experience after an open carpal tunnel release.  Those with more symptoms at the beginning also had more residuals in terms of testing for abnormalities. They concluded that the clinical severity of the CTS at the time of being evaluated, i.e., preop, was the most important factor in estimating the symptoms relief after surgical treatment. He concluded that the majority of variation between a patient’s outcome could not be explained by other measured variables, i.e., grip strength, other disease processes affecting the person at the same time such as trigger digit or de Quervain’s, the type of work the person was doing, whether it was the right or left hand, etc.  They concluded that future research should focus on the role of non-physical factors in predicting treatment outcomes after CTR.  I believe this ties into the anxiety level of each individual. It is important for us to make sure the person is prepared for an operation, and that they understand what to expect even in the event of an unexpected event.  In my experience, things will go very smoothly for the patient if she is well-informed and there aren’t all sorts of other conflicts going on such as fighting with her employer or the spouse, etc.