What is typically considered last resort in treating Carpal Tunnel Syndrome?

• A. NSAIDs
• B. Splinting
• C. Steroid injections
• D. Surgical release

Answer: (D)

When managing carpal tunnel syndrome, the initial goal is to relieve pressure with nonoperative measures, since they address symptoms without permanently addressing the compression. Splinting the wrist, especially at night, helps keep the canal open and reduces nerve irritation. NSAIDs may help with pain, and corticosteroid injections can offer short-term relief by reducing inflammation around the nerve. But these approaches don’t remove the structural compression inside the carpal tunnel. Surgical release directly relieves the pressure by cutting the transverse carpal ligament, allowing the median nerve to recover and function more normally. It’s typically considered after nonoperative treatments have failed to provide lasting improvement or if there is evidence of ongoing nerve compromise, such as persistent numbness, weakness, or thenar muscle atrophy. In these scenarios, surgery offers a durable, definitive solution, making it the last resort in standard management.