Surgery possible for Strasburg to fix carpal tunnel neuritis

Stephen Strasburg's follow-up exam with a hand specialist confirmed the Nationals' initial diagnosis of carpal tunnel neuritis. The veteran right-hander and the club are still discussing a course of action to address the injury, but manager Davey Martinez acknowledged surgery is a possibility.

"I'm going to talk to him, see what his options are and what he wants to do," Martinez said this afternoon during his pregame Zoom session with reporters. "But I think it's something that's going to have to be fixed. But I want to talk to him first and get his thoughts on things."

Strasburg has made only two starts this season, his 2020 debut pushed back two weeks because of what was then referred to as a nerve impingement in his right wrist. After receiving a cortisone injection and facing live hitters in a workout, he opened his Aug. 9 start with four scoreless innings but then gave up five runs in the fifth before departing and acknowledging he still felt numbness in his hand.

Strasburg tried to pitch again five nights later in Baltimore but lasted only two-thirds of an inning and threw only 14 pitches. He was placed on the 10-day injured list with carpal tunnel neuritis, a compressed nerve in the narrow passageway that connects the wrist to the hand.

It's a rare injury for baseball players, the only prominent recent example being David Price, who was diagnosed with carpal tunnel syndrome in May 2018 but still made 30 starts in the regular season, plus an additional five (including the clinching Game 5 of the World Series) for the Red Sox.

Price didn't miss any significant time due to his wrist ailment, but it's not clear if Strasburg's condition is comparable.

The Nationals and their 32-year-old ace must now decide the next course of action: rest, treatment or surgery.

"Are we conservative and let it try to heal?" Martinez said. "Or the other option is, it could be possible to have surgery. I want to talk to Stephen before we come up to any final conclusion."

Strasburg has not spoken to reporters since his Aug. 9 start. When he was scratched from his original July 25 season debut against the Yankees, he admitted the unprecedented nature of this season might influence his approach to trying to pitch through physical ailments.

"To be frank, this season's kind of a mess to begin with," he said that afternoon. "I've got to think about big picture here. It's my career, and I know that in the long run, it's important to try to make as many starts as you can. By putting yourself in a compromising position now, I don't know if it's really the best way moving forward. It is what it is. But I'm pretty optimistic that it won't keep me out very long."

After winning World Series MVP honors to complete perhaps the healthiest season of his injury plagued career, Strasburg opted out of the remainder of his contract with the Nationals and then re-signed for a larger seven-year, $245 million deal that runs through 2026.

With only five weeks left in the 2020 regular season, his time for returning to pitch this year is running thin, leaving the Nats to try to compensate for the loss of one of their most important arms.

"My concern is always Stephen," Martinez said. "I hope that he recovers as quick as possible, regardless of whether he pitches again this year or not, and that he's ready to go in spring training of next year. We'll see what happens after I talk to him, what his plans are and what he wants to do, and we'll go from there.

"But he's going to be missed, no matter what. Every start with him, it was always good every five days to put his name in there and watch him do his thing. He'll be missed, but the rest of these guys know what they need to do. They'll pick up the slack, and we'll go from there."