Surgery may have an edge over injections for carpal tunnel syndrome
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- Reviewed by Anthony L. Komaroff, MD, Editor in Chief, Harvard Health Letter; Editorial Advisory Board Member, Harvard Health Publishing
If you develop carpal tunnel syndrome — a pinched nerve in the forearm that causes numbness or tingling in the thumb and certain fingers — your doctor might recommend one of two treatments. One is a steroid injection that reduces swelling and pressure on the nerve. The other is surgery that permanently removes pressure on the nerve. Which treatment is best to start with? Probably surgery, according to a randomized trial published June 14, 2025, in The Lancet. The study involved almost a thousand people (average age 58) with carpal tunnel syndrome who were randomly assigned to receive either steroid injections or a referral for surgery. After 18 months, 61% of the people who’d had surgery had recovered from carpal tunnel syndrome, compared with 45% of the people who’d received injections. Moreover, 57% of the people in the surgery-first group recovered without needing additional treatments, compared with 13% of the people in the injection-first group. And 49% of the injection group ultimately needed surgery to recover.
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About the Author
Heidi Godman, Executive Editor, Harvard Health Letter
About the Reviewer
Anthony L. Komaroff, MD, Editor in Chief, Harvard Health Letter; Editorial Advisory Board Member, Harvard Health Publishing
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