What are the criteria for going ahead with carpal tunnel surgery?

Pain or weakness: If you can't stand the pain or the numbness despite conservative therapy surgery should be considered. Most important is weakness and / or muscle wasting (atrophy). If you have that, get surgery. What strength you lose you may not get back. Surgery is to prevent further loss. Good news--carpal tunnel surgery has a 90% success rate.

You're tired of it: If you have exhausted conservitive treatment and you are tired of putting up with the symtoms then you and your doc can talk about surgery. Also intractable pain, loss of two point discrimination or wasting of the muscle at the base of the thumb are all reasons to consider surgical treatment.

Not better: Carpal tunnel surgery is an option if you have been thoroughly evaluated by a specialist, the diagnosis has been confirmed with nerve studies and you have failed appropriate conservative measures. Having said that, the surgery had a good success rate.

Persistent symptoms: If you have persistent symptoms of numbness, weakness or pain with a diagnosis of CTS despite trying some conservative management including a splint, anti inflammatories, or steroids then you really should consider surgery. the success rate is very good at over 90%. Surgery will delay any further injury to the nerve which can even lead to permanent nerve damage if not managed appropriately.