Balance the small benefits and potential risks of carpal tunnel release surgery

At long-term follow-up, surgery probably provides better clinical improvement compared with splinting and manual therapy, but the benefits of surgery in symptoms and hand function seem to be small compared with non-surgical treatment. The decision for a patient to opt for surgery should balance the small benefits and potential risks of surgery.

Patients with severe symptoms, a high preference for clinical improvement and reluctance to adhere to non-surgical options, and who do not consider potential surgical risks and morbidity a burden, may choose surgery.

Alternatively, those who have tolerable symptoms, have not tried non-surgical options and want to avoid surgery-related morbidity can start with non-surgical options and have surgery only if they fail to achieve a satisfactory symptom state with non-surgical options.