Editing Carpal tunnel syndrome (section)

=== Surgery ===
{{Main|Carpal tunnel surgery}}
[[File:Carpal Tunnel Syndrome, Operation.jpg|thumb|Carpal tunnel syndrome operation]]
Release of the transverse carpal ligament is undertaken in [[carpal tunnel surgery]]. The purpose of cutting the transverse carpal ligament is to relieve pressure on the median nerve, and this is a type of [[nerve decompression]] surgery. It is recommended when there is constant (not just intermittent) numbness, muscle weakness, or atrophy, and when night-splinting or other palliative interventions no longer alleviate intermittent symptoms.<ref name=Hui_2004>{{cite journal | vauthors = Hui AC, Wong SM, Tang A, Mok V, Hung LK, Wong KS | title = Long-term outcome of carpal tunnel syndrome after conservative treatment | journal = International Journal of Clinical Practice | volume = 58 | issue = 4 | pages = 337–339 | date = April 2004 | pmid = 15161116 | doi = 10.1111/j.1368-5031.2004.00028.x | s2cid = 12545439 }}</ref> The surgery may be done with local<ref>{{Cite web|url=http://www.webmd.com/pain-management/carpal-tunnel/open-carpal-tunnel-surgery-for-carpal-tunnel-syndrome|website=[[WebMD]] | title=Open Carpal Tunnel Surgery for Carpal Tunnel Syndrome|access-date=July 9, 2015|url-status=live|archive-url=https://web.archive.org/web/20150707145827/http://www.webmd.com/pain-management/carpal-tunnel/open-carpal-tunnel-surgery-for-carpal-tunnel-syndrome|archive-date=July 7, 2015}}</ref><ref name=Youha>{{cite journal | vauthors = Al Youha S, Lalonde DH | title = Update/Review: changing of use of local anesthesia in the hand | journal = Plastic and Reconstructive Surgery. Global Open | volume = 2 | issue = 5 | pages = e150 | date = May 2014 | pmid = 25289343 | pmc = 4174079 | doi = 10.1097/GOX.0000000000000095 }}</ref><ref name=Nabhan>{{cite journal | vauthors = Nabhan A, Ishak B, Al-Khayat J, Steudel WI | title = Endoscopic Carpal Tunnel Release using a modified application technique of local anesthesia: safety and effectiveness | journal = Journal of Brachial Plexus and Peripheral Nerve Injury | volume = 3 | pages = e35–e38 | date = April 2008 | pmid = 18439257 | pmc = 2383895 | doi = 10.1186/1749-7221-3-11 | number = 11 | doi-access = free }}</ref> or regional anesthesia<ref name=AAOS /> with<ref>{{cite journal | vauthors = Lee JJ, Hwang SM, Jang JS, Lim SY, Heo DH, Cho YJ | title = Remifentanil-propofol sedation as an ambulatory anesthesia for carpal tunnel release | journal = Journal of Korean Neurosurgical Society | volume = 48 | issue = 5 | pages = 429–433 | date = November 2010 | pmid = 21286480 | pmc = 3030083 | doi = 10.3340/jkns.2010.48.5.429 }}</ref> or without<ref name=Youha /> sedation, or under general anesthesia.<ref name=Nabhan /><ref name=AAOS>{{Cite web|url=http://www5.aaos.org/icm/PrintModule.cfm?module=icm002|title=AAOS Informed Patient Tutorial – Carpal Tunnel Release Surgery|publisher=The [[American Academy of Orthopaedic Surgeons]] | access-date=July 9, 2015|url-status=dead|archive-url=https://web.archive.org/web/20150719060013/http://www5.aaos.org/icm/PrintModule.cfm?module=icm002|archive-date=July 19, 2015}}</ref> In general, milder cases can be controlled without surgery for months to years, but severe cases are unrelenting symptomatically and are likely to result in surgical treatment.<ref>{{cite journal | vauthors = Kouyoumdjian JA, Morita MP, Molina AF, Zanetta DM, Sato AK, Rocha CE, Fasanella CC | title = Long-term outcomes of symptomatic electrodiagnosed carpal tunnel syndrome | journal = Arquivos de Neuro-Psiquiatria | volume = 61 | issue = 2A | pages = 194–198 | date = June 2003 | pmid = 12806496 | doi = 10.1590/S0004-282X2003000200007 | doi-access = free }}</ref>