LYCOS RETRIEVER 
Carpal Tunnel Syndrome: Patients
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In general, patients recover very quickly following carpal tunnel syndrome surgery. The incision may be tender for six to 12 weeks after surgery. For two to three weeks after surgery repetitive activities are discouraged. Heavy activity should be avoided for four to six weeks after surgery. Sensation returns quickly, while strength returns over a three- to six-month period. Recurrence of carpal tunnel syndrome does occur but is quite unusual and may be related to technical error at the time of surgery.
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Orally administered corticosteroids have been shown to be more effective than NSAIDs or diuretics in the short-term treatment of carpal tunnel syndrome. The optimal corticosteroid dosage remains to be determined. In one prospective, randomized, double-blind, placebo-controlled trial (73 patients), global symptom scores for carpal tunnel syndrome were significantly improved at two weeks and four weeks in patients randomized to receive prednisolone in a dosage of 20 mg per day for two weeks, followed by 10 mg per day for two weeks.17 [Evidence level B, lower quality RCT] No major adverse effects were noted. The study ... found that NSAIDs and diuretics conferred no greater benefit than placebo.
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Every year more than 200,000 people in the US undergo surgeries for carpal tunnel syndrome. Surgery for CTS is among the most common hand surgeries. In various trials, 70 - 90% of patients who underwent surgery were free of nighttime pain afterward.
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The cause of the damage is subject to some debate; ... it seems likely that abnormally high carpal tunnel pressures exist in patients with CTS. This pressure causes obstruction to venous outflow, back pressure, edema formation, and, ultimately, ischemia in the nerve.
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Other conditions may ... be misdiagnosed as carpal tunnel syndrome. Thus, if, based on history and physical examination, a CTS diagnosis is suspected but not clear, patients will likely be tested electrodiagnostically with nerve conduction studies and electromyography; MRI or ultrasound imaging are also used.[15][16][17]
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The predisposing factors that cause median nerve compression andcarpal tunnel syndromeare unknown. Most experts believe that the condition is made worse by prolonged wrist positioning (either flexion or extension), trauma (such as fractures of the wrist or hematoma formation in the carpal tunnel), osteoarthritis, forms of inflammatory arthritis such as rheumatoid arthritis, or inflammation of tendons (tendonitis) in the wrist. There is a higher incidence ofcarpal tunnel syndromein patients with diabetes or thyroid disease as well as patients who are pregnant or on hemodialysis.
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