Mild, Short-Duration Symptoms
Short duration and low severity favor a conservative trial.
- <3 mo: Typical duration (short symptom history)
- Normal: EMG finding (no denervation)
- Injection: First-line choice (conservative option)
- Low: Surgery need (usually deferred)
Why mild cases stay conservative
Low severity and short duration predict good injection response.
Trial of Steroid Injection
A single injection tests symptom response before escalation.
- Days: Relief onset (short placeholder)
- Variable: Response rate (depends on severity)
- ~2: Repeat limit (before reconsidering)
- Relapse: Escalation cue (triggers re-evaluation)
Assessing injection response
Symptom relief duration guides whether surgery becomes necessary.
Symptom Duration Threshold
Longer duration steadily shifts risk toward the surgical side.
- ~6–12 mo: Threshold (placeholder range)
- Rising: Risk trend (with duration)
- Rightward: Marker motion (on duration axis)
- Moderate: Decision weight (combined with severity)
Crossing the duration line
Chronic duration alone can tip the balance toward surgery.
Moderate-Severe / EMG Denervation
Denervation signs on EMG strongly favor surgical release.
- Denervation: EMG finding (axonal loss signs)
- Limited: Injection value (short-term only)
- Rising: Nerve risk (delay raises damage)
- Higher: Surgical urgency (placeholder note)
Denervation changes the calculus
Nerve damage signs override a simple duration-based decision.
Surgical Release Decision Point
Combined severity and duration cross into the surgery zone.
- Ligament release: Procedure (transverse carpal ligament)
- High: Success rate (placeholder estimate)
- Weeks: Recovery (short placeholder)
- Low: Recurrence (placeholder estimate)
Committing to surgery
Release is chosen once conservative options are exhausted.
This threshold model is a simplified teaching placeholder only.