Use of a wrist splint whenever possible to keep the wrists at the neutral position. Exercises as described above. Instructions regarding prevention as outlined above. In some cases, conservative treatment is not successful. Surgery is then needed.
Surgery is a straight-forward outpatient procedure, which can be done under regional anesthesia.
The usual procedure involves making an incision along the skin crease next to the wrist, dividing the thick flexor retinaculum, and freeing the median nerve. The skin is then sutured together, and a bulky dressing applied. A newer technique using a small keyhole incision and dividing the flexor retinaculum with the help of an arthroscope is sometimes used. The advantage is a smaller incision. The disadvantage is inability to visualize the median nerve at the time of surgery, so it is not indicated in all cases.