Recurrent carpal tunnel syndrome is fortunately rare. Usually after a transverse carpal ligament release, after a carpal tunnel release, patients get better and they never have a recurrence. In the rare circumstances when they do, generally I try to avoid surgery because the fact of the matter is that the data shows that in a revision carpal tunnel release the outcomes are not as good as with a primary carpal tunnel release. So generally if we can avoid going back in and having to operate a second time, that’s optimal. Generally the treatment would be: perhaps some hand therapy, perhaps a cortisone injection, maybe splinting for a period of time. If I’m concerned, I’d get a new nerve study to assess to see if there is still slowing of the median nerve at the carpal tunnel because it is possible that there could be an incomplete release of the transverse carpal ligament. That would be the most common cause of persistent symptoms after carpal tunnel release.