carpal tunnel syndrome

[Erik__0]

  I have had several bouts with carpal tunnel over the last two years.  A couple of the bouts have been very severe and included the typical numbness and also pain shooting up past elbows.  One episode required a steroid dose pack which relieved pain. The last couple of episodes have been relieved by night splints and NSAIDS, and rest.  I am on low dose daily prednisone with occasional increases in dosage with fast tapers due to asthma.  I have hypothyroidism and undifferentiated connective tissue disease as well.
  I have never been to a neurologist, and right now the pain is very minimal, as is the numbness.  The hands wake up numb about twice a week.  Although I have had episodes of weakness, lately the hands seem to be doing better...I can even open jars right now.  I have never had this evaluated by a neurologist.  If symptoms are not constant, and only happen once or twice a week, are home remedies enough.  Would delaying evaluation by a neurologist cause any worsening or permanant damage?  I don't mind the way they are right now.  However, if this is something that should be attended to sooner rather than later, I can do that too.
  Thanks.
  DEB
Dear Deb,
If conservative management (NSAIDS, splints, physical therapy) is working then that approach is best.  Surgery, (carpal tunnel release), is an option if symptoms become severe, interfere with activity and are refractory to conservative management.  One test, if not already completed, that may be helpful to quantify the extend of injury is an EMG/NCS.  Neurologist typically perform the exam.  If your symptoms are stable, then it may not be urgent matter to get an evaluation by a neurologist at this time; however, if symptoms persists or  worsen then a complete evaluation/exam, testing, and possible surgical referral may be the best option.  If you are interested in getting an evaluation at CCf call 1-800-CCF-CARE.  Good Luck.