Chris, any chance this is temporary from a recently increased work load? Mine usually gets worse in the Spring/early Summer when the rakes and shovels come out,. When it gets to the point of giving me a hard time sleeping, I usually call the Dr and get 10 days of prednizone (sp?) and am good for the rest of the season. Lately I've been playing in the garage more, and it is becomming more consistant through the year (yanking on ratchets, twisting screwdrivers, sanding parts etc.). I am not discouraging you from the surgery, but if it is temporary and managable with meds, you may not need it.