Posted on

What You Need To Know About Carpal Tunnel Release Surgery

Currently in the United States, there is a great epidemic of carpal tunnel syndrome that’s doubled in the past 25 years. Since most patients don’t report their condition, this number is estimated to be 3 times greater.

Doctors are rushing to perform risky and costly carpal tunnel release surgery on patients.  Hand surgeries have blossomed in the last 2 decades, and carpal tunnel release surgery is one of the most common surgeries performed. The result of this rush to surgery is an unprecedented amount of misery and pain.

The medical money machine

Most people trust their doctor will help with their health problems. For the most part doctors do help them. However, each doctor fights an instinct to remain economically solvent,

Remember, if your doctor makes you better, you don’t need to go back for that condition anymore – and their income from you drops off. So completely relieving a problem makes poor fiscal sense to a business like medicine which is driven by discomfort and disease.

Make no mistake; medicine is very much a business where profit is the bottom line. Just search the web for “carpal tunnel surgeons” and see how much ad space is devoted to doctors looking for new patients.

Carpal tunnel syndrome means big profits

Other than the diabetes epidemic, treating carpal tunnel syndrome has been the biggest gift to medicine. And the ongoing epidemic of carpal tunnel syndrome is driving a blind rush to perform carpal tunnel release surgery like never before.

So it’s not surprising that there’s been an explosion of ordinary people with hand pain being told they have carpal tunnel syndrome. Most of these are a complete misdiagnosis because doctors are riding the wave of the carpal tunnel syndrome epidemic. The result is that more and more doctors are telling their patients to have carpal tunnel release surgery. That’s just plain wrong…and dangerous!

There is NO cure for carpal tunnel syndrome

Surgeons usually say that carpal tunnel release surgery will cure the condition but that’s a fallacy. Carpal tunnel syndrome is a disease that doesn’t have a cure. The pain is due to median nerve compression, but why such compression occurs is unknown. Therefore we can only treat some of the symptoms such as pain. And surgically cutting the transverse carpal ligament is a quick fix for the pain…but it’s not cure…and your symptoms can come back.

Misdiagnosis of carpal tunnel syndrome

Carpal tunnel syndrome is probably the most misdiagnosed disease today. It’s mostly confused with wrist tendonitis or repetitive strain injury. Surgeons say that EMG tests can tell difference, but many studies show that’s not true at all.

So why does a doctor rush to perform carpal tunnel release surgery when you may not have carpal tunnel syndrome to begin with? Profit.

Surgery is great for doctors

Diagnosing a patient’s pain as carpal tunnel syndrome necessary so that expensive surgery may be prescribed. Surgery brings in lots more income to a doctor than if they prescribe good and proven conservative therapy for your hand pain instead. Many doctors claim conservative treatments have poor results, but their facts are wrong and inconsistent with the data; so much so that the American Association of Orthopedic Surgeons, under pressure from various groups, recommends doctors tell their patients to use ALL such conservative therapies FIRST, before considering surgery.

Failed carpal tunnel surgery

Any massage or physical therapist will tell you how many of their patients have avoided or cancelled surgery with massage therapy. We already know massage therapy techniques work very well to alleviate carpal tunnel syndrome. Sadly, these same therapists will also tell you how many patients come with carpal tunnel release surgery  that’s failed. Most see a return of pain in the same hand 1-2 years later.

Posted on

Diabetes And Carpal Tunnel Syndrome

If you have Type II diabetes you might be concerned that you will develop carpal tunnel syndrome. The fact is that carpal tunnel syndrome is 15 times more prevalent in people with diabetes compared to the rest of the population. So it is a very real concern and an issue that everyone with diabetes should know about.

How the Two Diseases are Related

Many studies have shown direct association between carpal tunnel syndrome and diabetes, but nobody really understands the relationship. Over 20% of diabetic patients have a compressive neuropathy like carpal tunnel syndrome or cubital tunnel syndrome. The most important fact is that if a patient  has limited wrist joint mobility in addition to having diabetes, the incidence of carpal tunnel syndrome skyrockets to 75%. If the patient is also obese, the probability of having carpal tunnel syndrome is even higher.

Diabetes is not a cause of carpal tunnel syndrome. But carpal tunnel syndrome may herald the onset of diabetes, or a sort of “indicator” of getting diabetes. That’s because occurrence of carpal tunnel syndrome often precedes a diabetes diagnosis by as much as 10 years.

So nobody knows for sure if carpal tunnel syndrome signals the onset of diabetes or if diabetes is the tip of a more general problem that also includes carpal tunnel syndrome. Each disease has a different physiology, and more than likely they have some basic pathology in common.

Precautions Treating Carpal Tunnel Syndrome

If you’re diabetic you should exercise caution in treating  your carpal tunnel syndrome. And if you have advanced diabetes as well as skin ulceration, neuropathy or peripheral vascular disease then you should employ specific safeguards during treatment.

Temperature Problems: Treating your wrist and forearm with ice or heat should be done carefully. Some patients with diabetes have an abnormal tolerance to skin temperature changes; in other words, they may not be able to sense extreme temperature changes appropriately. The discomfort a normal person senses with high or low temperatures on the skin (if with ice or a heating pad) can be diminished with diabetes. Thus, such therapy may inadvertently cause harm to the skin and tissues lying underneath.

Splinting Concerns: If you wear a carpal tunned brace you should also monitor it carefully if you are diabetic. Diabetics often have neuropathy and peripheral vascular disease. These can lead to skin erosion. If a diabetic patient is treating carpal tunnel syndrome, then  precautions should be taken against excess pressure and rubbing by a brace. Protect the skin with cushions wherever the splint touches the skin, especially at the open edges of the splint. Use ointments while wearing the brace to keep your skin hydrated and supple.

Carpal Tunnel Massage: Deep tissue myofascial release massage is a well-known method to get rid of carpal tunnel syndrome. Keep in mind that diabetics are especially sensitive in joints like the wrist. A trained therapist must perform the massaging because they understand how to apply the technique effectively.

Surgery Concerns: Only after you’ve exhausted all other therapies with no lasting results should you consider carpal tunnel surgery to get rid of your symptoms of carpal tunnel syndrome. Your surgeon should understand the impaired healing issues with diabetes. It is widely believed that a diabetic’s skin is the only tissue that has difficulty healing following surgery. But the fact is that all of the body’s tissues share a common healing physiology. If healing is impaired in one tissue (such as the skin) it will most likely be impaired in other tissues too, including surgically cut connective tissues, ligaments and nerves.

Posted on

In the long run steroid shots don’t help carpal tunnel patients

A new study finds that in the long run, steroid shots don’t help carpal tunnel syndrome patients. Steroid shots for carpal tunnel syndrome seem to help some patients, but only in the short term. Most of those injected end up having carpal tunnel surgery, according to a new report.

Isam Atroshi and co-investigators discovered that one year after diagnosis, 75 percent of carpal tunnel sufferers who had corticosteroid shots had opted to have surgery while more than 90 percent of those who did not get the shots had the surgery immediately.

According to the study, corticosteroids usually do not help the patient remedy symptoms enough to avoid surgery altogether. This is a surprising fact because many hand doctors order the shots routinely.

About 5 percent of American adults will get carpal tunnel syndrome. It often affects both hands. It is recommended to be treated initially with rest, splinting and massage. But if those don’t bring a patient any relief, then corticosteroid shots are ordered. And if that doesn’t work, the last step is carpal tunnel surgery.

The researchers injected high dose corticosteroid, low dose corticosteroid , or placebo into over 100 patients who had carpal tunnel syndrome and who already tried splinting alone, but had no positive results.

Ten weeks later, the patients who had the high or low dose corticosteroid reported less pain, numbness or tingling than those who had the placebo.

At the one year mark, 73 percent of the patients who got the high dose shots had surgery; and 81 percent of patients who got the low dose shots had surgery; 92 percent  of those who got placebo shots had surgery.

But the American Association of Orthopedic Surgeons says that doctors should tell their patients to first try rest, splinting and massage before considering injections or surgery.

Doctors in the U.S. charge about $500 for one single corticosteroid shot. Carpal tunnel release surgery can cost over $4,000.

Posted on

Using ultrasound to treat carpal tunnel syndrome

Dr. M.J. Page, et. al. published a report in the 2012 The Cochrane Collaboration about using therapeutic ultrasound for carpal tunnel syndrome. Therapeutic ultrasound requires applying a round-headed instrument over the skin of the wrist and forearm to deliver sound waves. These sound waves are absorbed by the underlying tissues in order to help relieve pain and other symptoms of carpal tunnel syndrome.

They searched for study reports and found 11 randomized controlled trials that include 443 participants overall. The studies assessed the safety and benefit of therapeutic ultrasound for patients with carpal tunnel syndrome. The risk of bias of the studies was low in some of the studies and not clear or high in other studies. There is only poor quality evidence from very limited data to suggest that therapeutic ultrasound may be more effective than placebo for either short-term or long-term improvement of symptoms in people with carpal tunnel syndrome. There is also insufficient evidence to support the greater benefit of one type of therapeutic ultrasound regimen over another or to support the use of therapeutic ultrasound as a treatment with greater efficacy as compared with other non-surgical interventions for carpal tunnel syndrome. Few studies measured adverse effects of therapeutic ultrasound.

The investigators conclude that more research is needed to find out how effective and safe therapeutic ultrasound is for people with carpal tunnel syndrome. For it to be in wide use, therapeutic ultrasound needs to be as effective as other non-surgical treatment modalities like therapeutic massage of the wrist and forearm.

 

Posted on

How to Tell the Difference: Carpal Tunnel Syndrome vs.Tendonitis

Knowing the Difference between Carpal Tunnel Syndrome and Wrist Tendonitis is the First Step in Proper Treatment. This is a quick self-test which can show whether you have carpal tunnel syndrome or wrist tendonitis.

Of course, these are not definitive tests, nor are they final diagnoses. But they are the same tests your doctors performs in the office, and will give you a general direction for what’s causing your symptoms; carpal tunnel syndrome or wrist tendonitis.

If you answer YES to any of these tests, then you may have Carpal Tunnel Syndrome instead of Wrist Tendonitis.

1. With your fingers straight, flex your left wrist gently and as far as possible (i.e., bring your fingers as close to your wrist as you can). Then hold this position for 1 minute. (This is the Phalen maneuver.) Do your symptoms appear or get worse? Do you feel numbness?

2. Next, with your hand straight, lightly tap the skin over your wrist-crease. Tap left to right, and back again (This is the Tinel test.) Does it result in a tingling or “pins-and-needles” in the hand?

3. Now, with your hand straight, using your opposite thumb apply firm pressure to the entire width of your wrist-crease for 30 seconds. Relax one minute, and then apply firm pressure on the palm of the wrist-crease for 30 seconds. (This is the Durkan test.) Do either of these make your symptoms appear or get worse? Do you feel numbness?

If you answered NO to the above questions, then try the following test. If you answer YES to this test, then you may have wrist tendonitis.

1. Use two fingers to tap your flexor tendons just below your wrist-crease. These are the rope-like structures on the palm side (not the back side) of your forearm. Tap each tendon all along its length, half way to your elbow. Tap several times up and down on each tendon. Then tap vigorously all around your forearm. Does any of that reproduce your symptoms or make them worse?

Now repeat the above for the extensor tendons (on the back side) of your forearm. Does it reproduce your symptoms or make them worse?

2. Next, on the flexor surface (palm side) of your forearm, use your opposite fingers to carefully follow each individual muscle of your forearm (starting at the elbow) to its tendon as it courses through your lower forearm and all the way into your wrist. Then follow the tendon back to the muscle again.

Now repeat the above for the extensor tendons (on the back side)of your forearm.

As you course up and down the tendons, you might feel a “hot spot” – which is a point of tenderness. Tendonitis usually will involve one or two tendons. The tenderness will likely be in the wrist area, either in the hand (front or back) or just as the tendon enters the wrist. The tenderness may also extend well into the hand and all the way to the fingers.

If you experience such hot spots, you likely have tendonitis. And if those hot spots are on the extensor side (palm side) it can be confused with carpal tunnel syndrome.

How to Treat Wrist Tendonitis:

There are 3 steps you can take at home before seeing a doctor.

  1. Immobilize the Wrist
    Placing the wrist in the Micro-Soft Carpal Tunnel Brace is the first treatment step. Wrist tendonitis is due to recurrent irritation of the tendon and its sheath. By resting the tendon, the inflammation should decrease.
  2. Apply Ice
    Ice is one of the best methods of reducing inflammation and swelling. Ice also promotes blood flow to the area. You should apply ice intermittently throughout the day. Do not apply ice directly to the area, wrap the ice pack in a towel.
  3. Anti-Inflammatory Medications
    Non-steroidal anti-inflammatory medications will help control symptoms of pain, but more importantly they help in the treatment of wrist tendonitis to decrease inflammation and swelling of the soft-tissues. These treatment medications will decrease the inflammatory response which is the cause of the pain.

Warning: Prolong use of OTC NSAIDs such as ibuprofen and acetaminophen is extremely dangerous. Over 100,000 hospitalizations and 16,000 deaths per year are caused by the extended daily use of these drugs.

Posted on

Natural treatments for carpal tunnel syndrome

Even though Carpal-RX Enhanced Brace Therapy is the most effective therapy for relief of the majority of carpal tunnel symptoms there are other non-surgical natural remedies well-known to successfully provide carpal tunnel syndrome relief. They are listed in order of most-to-least effective.

1. Deep tissue Massage

Deep tissue massage on your wrist and forearm, applied by a medically trained professional, using the technique known as “myofascial release” drains fluid from the carpal tunnel. That results in pressure relief inside the carpal tunnel and therefore on the median nerve. Having a professional massage on your wrist and forearm every day for 4 weeks can be costly.

2. Yoga

Various studies have proven that yoga exercises can reduce symptoms of carpal tunnel syndrome. Like massage, yoga exercises should be performed as often as possible; preferably twice per day. Unlike massage, the yoga needs to be performed for several months to be effective. Yoga exercises are especially good for meditative purposes as well, giving the pain sufferer the double benefit from one technique. Specific wrist, hand, and finger yoga techniques can drain fluid inside the carpal tunnel just as deep tissue massage would.

3. Acupuncture

Another treatment considered a natural treatment for carpal tunnel syndrome  is acupuncture. It is said that acupuncture releases blockages (which cause pain) along energy pathways in the body. The acupuncture needles are said to enhance energy flow along these pathways. But it’s more likely the needles release pain relieving chemicals and promote circulation. The number of acupuncture sessions depends on how long you’ve had symptoms, their intensity, your general health, and how much you use your hands. The only problem is that once the needles are removed, the pain will return after a few hours or (if you’re lucky) a day or two later.

Posted on

How do doctors diagnose carpal tunnel syndrome?

Just like other conditions of the nervous system, you must diagnose and treat carpal tunnel syndrome early in order to prevent damage to the median nerve inside your carpal tunnel. Your doctor can perform exams to determine if you have carpal tunnel syndrome or simple wrist tendonitis. Some of the tests your doctor will can be done at home.

Your doctor performs a physical exam of your hands, arms, shoulders, and neck. This exam is important because your doctor can determine if the symptoms are related to carpal tunnel syndrome or to daily activities. The exam can also determine if other painful conditions are present that produce symptoms mimicking carpal tunnel syndrome.

Your wrist is first examined for tenderness, swelling, warmth, and discoloration. Each finger is tested for sensation and the muscles at the base of your hand are examined for strength and signs of wasting. Routine lab tests and X-rays reveal diabetes, arthritis and fractures.

If your doctor suspects you have carpal tunnel syndrome you may be asked to have an electro-diagnostic test to confirm carpal tunnel syndrome. In a nerve conduction study, very thin electrode needles are placed into your hand and wrist. Tiny electric shocks are applied and the speed with which nerves transmit impulses (travelling through your carpal tunnel) is measured. This is an uncomfortable procedure, expensive, and will not diagnose early carpal tunnel syndrome. It is also fraught with false results, and many doctors are no longer relying on it.

Electromyography or EMG is similar except that a fine needle is inserted into a muscle to determine conduction time and the severity of median nerve damage. In severe cases, impaired movement of your median nerve can be imaged with ultrasound. And while magnetic resonance imaging (MRI) shows the anatomy of the wrist, it is not useful in diagnosing carpal tunnel syndrome.

Posted on

Hand Pain Conditions

When you experience hand pain and other symptoms in your hand, fingers or wrist, it could be a sign that one of a few conditions are starting to develop in your hand and wrist. This summary describes the most common hand conditions and what can cause them.

Carpal Tunnel Syndrome

Carpal tunnel syndrome is NOT a repetitive strain injury even though it seems to occur with greater prevalence in certain jobs that require a lot of hand activities. Instead, it is the most common and widely known of the entrapment neuropathies in which the body’s peripheral nerves are compressed or traumatized. It’s actually considered a disease with no known cause. Symptoms of carpal tunnel syndrome develop when the median nerve (located inside of the wrist) becomes compressed. This produces feelings of pain, burning, numbness and tingling within the fingers (especially the thumb, but not the pinky), hand and wrist. Early onset usually starts with numbness and tingling in the hand and fingers. Patients generally report waking up at night to shake out their numb hand and fingers. The range of motion and grip strength of the hand may also be affected.

Repetitive Strain Injury

Repetitive strain injury (RSI) is also called repetitive motion injury, repetitive stress injury, repetitive motion disorder, cumulative trauma disorder, occupational overuse syndrome, overuse syndrome, or regional musculoskeletal disorder. It represents an injury of the musculoskeletal and portions of the nervous systems that may be caused by repetitive tasks, forceful exertions, vibrations, mechanical compression or sustained or awkward positions. RSI can occur just about anywhere in the body, but when it afflicts the hands there are many related symptoms. These may be pain or soreness in the hand, wrist, and forearm that keeps occurring. You may also experience tingling, numbness, coldness, loss of sensation, loss of grip strength, lack of endurance, weakness, and fatigue. The muscles in your forearms might feel hard and wiry. While you lie in bed you could experience pain or numbness.

Wrist Tendonitis

Wrist tendonitis is one of the most common types of repetitive strain injury. Tendonitis also may affect parts of the body other than the hand, where it would e called shoulder tendonitis or ankle tendonitis, for instance. Wrist tendonitis occurs when a tendon within the wrist and forearm becomes inflamed and swollen. And since tendons are present throughout the body, such inflammation can occur just about anywhere. Wrist tendonitis commonly develops as a result of active participation in sports or simply using the hands either repeatedly or forcefully. The sport most commonly associated with wrist tendonitis is rock climbing, where the tendonitis is most pronounced in the fingers. Also, office workers, jackhammer users, hairdressers, assembly line workers, cashiers, and transcriptionists are also highly susceptible to this condition.

Wrist Tenosynovitis

Wrist tenosynovitis is a type of repetitive strain injury that is similar to wrist tendonitis in a number of ways. As opposed to an inflammation of the tendon as in tendonitis, those with tenosynovitis develop an inflammation of the fluid-filled sheath that surrounds the tendon. More often than not, cases of tenosynovitis develop within the fingers, and the syndrome is known as “trigger finger”. Those with a case of wrist tenosynovitis may experience limited range of motion within the fingers, and may feel a cracking occurring when they try to straighten their affected fingers. High risk jobs that require repetitive hand and finger movements are associated with wrist tenosynovitis. These include secretarial jobs, assembly work, meat packing, and various warehouse occupations.

DeQuervain’s Syndrome

DeQuervain’s syndrome is also known as BlackBerry thumb, gamer’s thumb, washerwoman’s sprain, radial styloid tenosynovitis, de Quervain disease, de Quervain’s tenosynovitis, de Quervain’s stenosing tenosynovitis, mother’s wrist, or mommy thumb. It is a type of repetitive strain injury that primarily affects the thumb. Two tendons that control the movement of the thumb contain sheaths which envelop the tendons. When the sheaths become inflamed, pain and swelling may occur within the thumb. People with DeQuervain’s syndrome may experience symptoms such as a lack of ability to grip with the affected thumb. The thumb may be painful or tender, and there might be swelling over the thumb side of the wrist.

Posted on

Chronic Pain: What Is It?

Acute pain is a normal sensation that’s activated in the nervous system to alert you about possible injury and to take precautions. Chronic pain is different. Chronic pain persists because a nerve’s pain signals keep firing for days, weeks, months or even years. There may have been an initial mishap like a sprained back, serious infection, or there may be an ongoing cause of pain like carpal tunnel syndrome, arthritis, cancer or ear infection. But some people suffer from chronic pain in the absence of any past injury or evidence of body damage. Many chronic pain conditions affect older adults. Common chronic pain complaints include headache, low back pain, cancer pain, arthritis pain, and neurogenic pain (pain resulting from damage to nerves, as in the wrist’s carpal tunnel).

A recent research report indicates that more than 1.5 billion people worldwide suffer from chronic pain and that approximately 3- 4.5% of the global population suffers from neuropathic pain, with incidence rate increasing in complementary to age.

The total annual incremental cost of health care due to pain ranges from $560 billion to $635 billion (in 2010 dollars) in the United States alone, which combines the medical costs of pain care and the economic costs related to disability days and lost wages and productivity.

More than 50 percent of all hospitalized patients experienced pain in the last days of their lives and although therapies are present to alleviate most pain for those dying of cancer, research shows that 50-75 percent of patients die in moderate to severe pain.

An estimated 20 percent of American adults (42 million people) report that pain or physical discomfort disrupts their sleep a few nights a week or more. One of the most common sleep depriving pains is that from carpal tunnel syndrome. A combination of pain, numbness and tingling usually wake patients with a need to shake out their hands.

If you are suffering from Chronic Hand Pain due to carpal tunnel syndrome:

The best therapy is one that opens up and widens your carpal tunnel to relieve the squeezing of your median nerve. And the earlier you decompress that nerve, the better your chances of regaining full strength and dexterity.

Widening your carpal tunnel requires physically expanding the bones inside your wrist joint. The Carpal-RX tension release day brace does exactly that. It keeps your carpal tunnel open, letting your nerve decompress to return to normal again. The Carpal-Rx is extremely effective and completely safe and simple to use for all levels of carpal tunnel syndrome, wrist tendonitis and repetitive strain injury.

So if you have symptoms like hand or finger pain, numbness, tingling, burning, hand falling asleep, hand coldness, hand waking you at night, weakness and dexterity problems, you should start using the Carpal-Rx Tension Release Day Brace as early as possible.

Posted on

Average Out of Pocket Costs for Carpal Tunnel Surgery and Aftercare

“I don’t care about cost, my Insurance will pay for it!” Assuming that health insurance covers an elective surgery, such as for treatment of carpal tunnel syndrome, the same as it covers lifesaving surgery is an assumption that will haunt you, your bank account, and lifestyle for months or years to come; depending on your financial situation.

Assuming that you are covered is probably the worst assumption you can make when deciding if you should pursue surgery for treatment of your carpal tunnel syndrome; especially when it comes to the aftercare costs. The national average for insurance deductibles and co-pay, for carpal tunnel surgery, is $4,426. This figure is not something we pulled out of the air; it is supplied by the American Insurance Institute.  It is a staggering amount of money, for most people to pay, especially for a procedure with a 52% failure rate.

A recent study published in the Proceedings of the National Academy of Sciences found that only 14% of Americans understood their own insurance policy. Not knowing what your medical policy covers and the price that you must pay, in deductibles and co-pay for carpal tunnel surgery, will cost you dearly – in money, lost job time, and physical pain.

Carpal tunnel surgery (CPT Code 64721) costs vary widely, ranging from $3,011 to $7,202 per hand. Aftercare (post-operative recovery, rehabilitation, etc.) can double these figures and the out of pocket cost.

A 2013 survey of the American Insurance Institute shows that the average American, with health insurance, must pay an average cost (deductible plus any co-payments) of $1,182 for the carpal tunnel surgery, and an additional $3,244 in post-operative costs. Nobody is “fully covered” for carpal tunnel surgery.

What determines how much you pay in out-of-pocket costs?

While that question is simple, the answer is complex and different for everybody because it depends on many factors. Carpal tunnel surgery is almost universally considered “elective surgery” which is one reason costs vary so much. For a private insurer (Cigna, Kaiser, Blue Cross, etc.) factors that most heavily influence how much you pay out-of-pocket are:

 How much deductible is in your medical insurance policy?

Normally you must pay a deductible (typically $1,000-$2,000) before your insurance carrier starts paying a percentage (usually 70%) of the remainder. That means you will likely pay 30% of the remainder. Aftercare usually is not considered “necessary” by the carrier and most often is not covered at all.

Do you have co-insurance or supplemental insurance?

Additional insurance can fill your out-of-pocket gap, but only about 8% of insured Americans have co-insurance. Even then, many co-insurance carriers do not cover elective surgery (which is what carpal tunnel surgery is).

Will your carpal tunnel surgery be in-network or out-of-network?

Most insured Americans are part of a healthcare network which means you must see a surgeon who participates in the plan. If you go outside the network you will pay even more – often the greater proportion of your surgery.

Will your surgery be performed in an ambulatory center or hospital?

This depends on your preference, where you live, your insurance carrier’s preference, and your doctor. Hospital costs are always much higher compared to those in an ambulatory or surgical center.

Where do you live?

Where you live or have the surgery can make a huge difference in your out-of-pocket costs.

Do you have Medicare?

The National Center for Medicare and Medicaid says Medicare patients (who typically have 80% coverage) have an out-of-pocket cost of $887 for the surgery, and $1,265 for aftercare (totaling $2,152).

Are you entitled to Worker’s Compensation?

Worker’s Compensation benefits for carpal tunnel surgery are denied 97% of the time on the first attempt to file for benefits. Compensation varies widely by state, and if successful, the time from filing your claim, through your appeal and to your surgery averages 14 months.

Are you entitled to Veterans benefits?

The VA evaluates your symptoms against certain criteria and determines if it is a service-connected disability. Denial of VA claims at the outset is almost the norm. Once you are denied from the regional office you should consider having an attorney represent you, where you must pay up-front, non-refundable fees.