Surgery

At its most effective, surgery can be used in the treatment of carpal tunnel syndrome. However, only if the diagnosis has been made on the basis of a careful history and physical examination, in the presence of paraesthesia, possibly muscle wasting, and median nerve compression confirmed by nerve conduction tests. In these conditions surgery can be rewarding although it must always be stressed that the relief is of sensory pain distal to the carpal tunnel and not pain or discomfort proximal to the carpal tunnel.

Surgery may also be recommended to release the common extensor tendon and common flexor tendon at the elbow in the presence of the intractable pain of epicondylitis. In De Quervain's, a longitudinal incision over the relevant tendon may be of help, but only if injecting steroids between tendon and sheath has failed.