For patients who have not been able
to find relief of their carpal tunnel syndrome symptoms,
surgery may be their best option. We offer a minimally
invasive procedure that has been performed on thousands
of patients with excellent results. Our technique
involves making a very small incision at the wrist
and takes approximately 10 minutes to perform. Most
patients who have had this procedure are back doing
their normal daily activities within 2 to 3 days.
What Is Carpal Tunnel
Carpal tunnel syndrome is a common condition affecting
the thumb and next two fingers of one or both hands.
Its symptoms usually first appear as episodic tingling
and numbness associated with strenuous or repetitious
wrist and hand motion such as: driving a car, knitting,
typing, etc. If left untreated, this syndrome can
progress until the patient feels a constant numbness
and generalized weakness of the hand. This makes
even simple tasks, such as buttoning a shirt or
opening a jar lid, increasingly difficult. Carpal
tunnel syndrome often awakens the sufferer during
the night with burning sensations in one or both
Who Gets Carpal Tunnel Syndrome?
Anyone can get carpal tunnel syndrome, but it is
often associated with jobs and hobbies requiring
repeated wrist and hand activities. This commonly
includes carpenters, mechanics, musicians, painters,
knitters, artists, and golfers. However, it may
not be related to any one particular activity.
associated with carpal tunnel syndrome can also
contribute to its development. These include pregnancy,
arthritis, diabetes, blood vessel abnormalities,
tendonitis, obesity, nerve tumors or cysts, and
Occupations Seem to be Related to Carpal Tunnel
Musicians, Meat Packers/Carvers, Hair Stylists,
Barbers, Typists/Word Processors, Bank Tellers,
Welders, Tree Trimmers, Mechanics, Carpenters, Plumbers,
Techers, Cashiers, Electricians, and many more
people who use tools that require a tight grasp
or have vibrating parts.
What Causes Carpal Tunnel
syndrome can be the result of continued minor injury
to the wrist or the contents of the carpal tunnel.
This injury leads to swelling of the contents of
the tunnel, and compression of the very delicate
median nerve, which is trapped in this tunnel with
other less affected structures like tendons.
Nerve entrapment by this pressure causes tingling
and numbness, and can also lead to nerve damage.
damage, in turn, creates atrophy of those muscles
the nerve controls, such as the prominent muscles
at the base of the thumb. When ignored over a period
of months, the nerve injury can become permanent
and irreversible. Some patients are more susceptible
to carpal tunnel syndrome because they are born
with a smaller carpal tunnel.
Is Carpal Tunnel Syndrome Diagnosed?
In general, carpal tunnel syndrome is a clinical
diagnosis. That is, the diagnosis is made by carefully
listening to the patient. In addition to the history
given by the patient, a diagnostic procedure known
as an EMG (Electromyogram Study) is often required.
This test measures the electrical integrity of the
nerve and its connection to the muscles. It will
also show the degree of nerve damage, and help eliminate
other possible causes for the patient's symptoms.
How Is the Syndrome Treated?
treatment consists of anti-inflammatory agents,
wrist splinting, and occasionally steroid injections
into the wrist. Behavioral adjustments in lifestyle
that may be augmenting symptoms are helpful in the
non-operative treatment fails, the mainstay of treatment
is the carpal tunnel release. This involves cutting
the transverse carpal ligament to relieve the pressure
on the nerve. This is the standard of care worldwide,
and there are several different surgical approaches
to achieve this goal. We choose to make a one-half
inch incision in the wrist crease. We then use a
specially designed instrument that allows us to
reach under the ligament and cut it from beneath,
preserving all other structures.
We have performed this procedure on several thousand
patients. We have published our statistics in internationally
recognized medical journals and our statistics are
at least as good as those of surgeons who use other
surgical approaches. Only two to three stitches
are required to close the incision, and 24 hours
later, a Band-Aid is the only visible evidence of
Are the Results of Carpal Tunnel Release Surgery?
Immediately after surgery,
there is usually a varying degree of discomfort, which is alleviated by taking non-aspirin
products and propping the wrist on pillows at night.
You may use plenty of ice more helpful than
pain pills on the days and weeks following
the procedure. You may use your hand or hands as
much as comfort will allow. Overdoing your hand
function, however, will cause some additional soreness
which is remedied by rest and ice.
week after surgery, your sutures may be removed.
By three to fours weeks after surgery, most patients
will have resumed all activities of daily living,
including return to work.
with any surgical procedure, there are possible
complications. Why trying to get a nerve out of
a tight spot, that nerve or its branches may be
injured. Fortunately, this is extremely rare in
carpal tunnel surgery.
Expectations After Surgery
symptoms resolve quickly after a carpal tunnel release.
These include the numbness and tingling that comes
and goes throughout the day, and the numbness and
burning that arises during the night. However, complete
numbness may not resolve immediately after surgery;
if sensation does return, it may take months or
you have significant atrophy or muscle loss in the
the thenar muscles, this too may not return. If
it does, it may take years. Many of our patients
have associated tendonitis and arthritis to complicate
the picture. Pains and aches coming from these entities
will not change.
general, however, carpal tunnel release is one of
the most successful and effective surgical procedures