- There is no resolution of electrodiagnostically confirmed Carpal Tunnel Syndrome following a 4 week trial of conservative treatment, or
- There is significant muscle wasting.
The standard surgery for Carpal Tunnel Syndrome is the transection of the transverse carpal ligament ("carpal tunnel release"), either by open incision or endoscopic surgery.
In the vast majority of cases, bilateral electrodiagnostic studies should be performed prior to surgery to confirm the diagnosis.
In cases of surgical failure a second opinion may help determine the need for repeat surgery.
Fitness to Work
With conservative treatment, expected duration of absence:
- With modified duties: 0 – 1 week
- Without modified duties: 0 - 4 weeks.
Modified duties are generally required if work involves certain types of vibration, repetition and force. Worksite analysis and modifications may be required to help prevent recurrences.
After surgery - most patients can return to light hand use following the removal of sutures, but may not tolerate the use of tools that require a power grip for an average of 6 to 8 weeks.
Permanent Clinical Impairment Criteria
Assess, if indicated, 2 years after surgery to allow for adequate nerve regeneration. Impairment assessment is based upon ongoing median nerve dysfunction.
