Subjective symptoms influence patients’ carpal tunnel surgery decisions

Subjective symptoms are the most important consideration for patients who have carpal tunnel syndrome (CTS) in deciding whether to undergo carpal tunnel release. Those who cancel surgery have self-reported outcome scores similar to those who choose to undergo the procedure.

In a retrospective study, Gong and coworkers reviewed data from 282 women with a confirmed diagnosis of CTS of unknown cause. All had been recommended for surgery, but after discussion with the operating surgeon about the procedure, postoperative concerns, possible functional outcomes, and possible complications, some (n = 36) changed their minds.

The highest-ranked reason for choosing surgery was the severity of the symptoms rather than fear of progression or a positive electrodiagnostic result. The main reason for canceling surgery was some degree of symptom improvement during the preoperative waiting period rather than fear of undergoing surgery or economic burden; some women canceled because they were concerned that improvement would be temporary, symptoms would recur, and the condition might return or worsen. There were no important differences between the groups with respect to age or socioeconomic status.

The authors noted that electrodiagnostic findings tend to affect a physician’s choice of treatment but are not compelling factors for patients considering surgery.