With systmic inflamation, would carpal tunnel surgery help or would the condition likely return?

Depends: If the carpal tunnel syndrome is severe you may need surgery regardless in order to prevent n. Damage. If the problem is not severe the inflammation can be treated first while the carpal tunnel is treated. Options for carpal tunnel include splints, injections, surgery. None of these are a guaranteed permanent cure. It can recur due to inflammation, scar tissue after surgery, worsening arthriti.