For carpal tunnel syndrome, when is open surgery preferred over minimally invasive surgery (endoscopic), and what are the considerations?

Hi Carpal tunnel Syndrome (CTS) can sometimes be tricky. It is a compression of the median nerve at the carpal tunnel at the wrist. That compressive band is always there. Hence non-surgical methods, like anti-inflammatory medication, injections and splinting can all be done first. Symptoms may improve, but they may recur. As the causative problem is still present. Thus, it is hard to answer your question of how long does it take to get better. It also depends on whether there are other causes. Pregnancy is a risk factor for CTS, and the symptoms resolve after delivery.

Tendinopathy can be challenging to treat but the mainstay of treatment remains rehabilitation with physiotherapists and load management. In situations where this is not helping, then you might be offered Extracorporeal Shock Wave Therapy (ESWT) to help stimulate the tendon to heal itself, or in situations where tearing is noted within the substance, a Platelet-rich plasma (PRP) injection could be considered. Other injection treatments include prolotherapy or high volume tendon stripping. However, all injections, care must be taken to offload the tendon afterward.