It seems everyone in my office is having carpal tunnel surgery. The results seem pretty good. I'm having some of the same symptoms. How can I tell if the surgery would help me?

Carpal tunnel syndrome is the most common nerve compression problem of the wrist and hand. Even so, diagnosing CTS accurately can be a challenge. There's no single test that is 100 per cent sure.

Many doctors think that reviewing the patient's symptoms is enough to make the diagnosis. Others disagree and suggest that electrodiagnostic testing is needed to confirm the diagnosis -- especially before surgically releasing the soft tissues around the nerve.

A middle-of-the-road approach is often to treat the symptoms conservatively for up to six months and then decide. A hand therapist (usually a physical or occupational therapist) can teach you how to use your hands and wrists in such a way as to take pressure off the nerve that's getting pinched.

Nerve and tendon gliding exercises can help restore free motion of the nerve inside the carpal tunnel. The carpal tunnel is an opening or space formed by the circle of bones in the wrist. The nerve passes through these bones on the way from the elbow to the fingers.

If you don't get better and especially if you get worse, further testing can be done. Electrodiagnostic tests check to see if the nerve is functioning properly. Is it passing along messages and how fast is it going? Slowed or absent responses suggests the need for surgery to release the nerve.

If you haven't already seen an orthopedic or hand surgeon, then your first step is to make an appointment. An examination and history will help the physician evaluate you. Special clinical tests can be done in the office to look at motion, strength, and assess nerve irritation. The surgeon will be able to advise you about what treatment is best and what to expect.