How do you know you need surgery for carpal tunnel?

Well, remember what: I recommended....1st you need to verify the Dx of CTS you say you have in both hands. Have you seen a neurologist, gotten an EMG &/or NCV study? If not, I would consider that mandatory for you to avoid unnecessary surgery. Next, conservative treatment should always be #1, #2, #3 things to consider before surgery. We like to expedite surgery based upon EMG results, loss of hand strength & pain.

When nothing: Else works or there's changes in your hand muscles, it's a very quick surgery, doesn't require general surgery, ask surgeon about risks