Hi, I am an American Board Certified Neurologist; the expert to whom this question was originally addressed is not available now so the company has made this question available to other experts too and I am very glad to help you with your health concerns.
I have tried to answer your questions one by one below here;
1) Should I decide to have surgery?
The indication for carpal tunnel syndrome surgery usually are as follows;
a) Symptoms are progressing inspite of non-surgical conservative treatments
b) Symptoms are severe and not responding to non-surgical conservative treatments
c) Severe muscle weakness and/or muscle atrophy (muscle wasting)
d) EMG/Nerve conduction test showing severe carpal tunnel syndrome etc
If you have any one or more of the above criteria then surgery is commonly recommended.
2) Do you recommend open/release or endoscopic? Which is more successful with less post op discomfort and less recovery time?
Each of the above surgeries (open-release or endoscopic) has its own plus and minus. The overall success rate is somewhat higher with open surgery whereas the post op discomfort, recovery period etc are better with endoscopic surgery.
3) If I'm looking into non surgical options which are preferred and are any truly effective? As in, what else fixes it?
As far as non-surgical conservative approach the following guidelines are commonly employed;
The mainstay of treatment for the carpal tunnel syndrome is by giving rest to the wrist area as much as possible and this is accomplished by using a wrist splint & reduction in the repetitive movements of the hand as much as possible. Along with these measures PT/OT (physical therapy/occupational therapy) to the hand also tried. Steroid injection to the wrist area or Steroid Iontophoresis are few other options which can help in some patients. Another treatment option is Ultrasound guided PRF (pulsed Radio Frequency) treatment of the median nerve which can help in some patients.
You may please try the various above non-surgical options before considering surgery.
Please let me know if you have any further questions; and if you feel you have received the answer to your question please rate me so that I can receive credit for the time and effort put by me in answering your question.