Quick Answer: 10-20 Minutes

Myth: Carpal Tunnel Release Surgery it is a longer surgery that requires patients to go under general anesthesia. This is incorrect! At Modern Orthopaedics of New Jersey, we perform carpal tunnel release surgery with local anesthesia, meaning the patient is awake, and usually takes anywhere from 10-20 minutes.

Watch the video below to learn more!

Carpal Tunnel Syndrome: Causes, Symptoms & Solutions 

In this video, ‪Pete DeNoble from Modern Orthopaedics of New Jersey shares his comprehensive approach to diagnosing and treating Carpal Tunnel Syndrome. Learn about the symptoms, causes, physical exams, and treatment options, from bracing and supplements to cortisone injections, shockwave therapy, and surgical procedures like open carpal tunnel release and endoscopic surgery.

Introduction

here is how I approach carpal tunnel syndrome in my patients so first and foremost I try to First evaluate what the symptoms are so typically carpal tunnel syndrome symptoms are the following you often will have early on have tingling in the thumb index middle and part of the ring finger here that’s what’s called the median nerve distribution that’s where Sensation from those areas accumulated into the median nerve which then goes right through the carpal tunnel right in the see your palm here is where the carpal tunnel is and then it goes up through your forum and back up all the way up to your neck into your brain that’s how the signals are kind of transmitted and so when you have problems at the carpal tunnel where things get tight the symptoms you start to feel are in that distribution.

You also can in more advanc symptoms get weakness in the muscle because part of that nerve also is responsible for driving the muscle in the base of your thumb so sometimes if you get that kind of me of your thumb here if you get like a flattening or thinning out of that muscle you start to ECT possibly there’s some carpal tunnel syndrome going on where the signals aren’t getting to the muscle to drive the the motor response which is basically thumb opposition which allows you to kind of bring your thumb and curve it around and touch the pinky and other fingers and kind of get it out of your palm here so that’s the function of the median nerve and because the median nerve goes through the carpal tunnel the carpal tunnel is sort of oriented going from your forarm into your palm.

Inside that carpal tunnel there are nine tendons in one nerve the median nerve nerve and the tissue around the flexor tendons which are responsible for flexing all your fingers and your thumb is called flexor tinos synovium. Now that tissue with repetitive use and maybe other conditions like diabetes maybe amalo dois can start to increase pressure inside that tunnel. Now that tunnel doesn’t stretch as pressure goes up it just starts to squeeze the nerve more and that’s when your symptoms start to come about.

So there are physical exam tests that I do whether it’s tapping squeezing ing bending that can elicit or exacerbate those symptoms and those exam findings can actually help me towards achieving even just a diagnosis on physical exam and history alone. When I’ve confirmed a diagnosis of carpal tunnel here’s how I like to approach it.

How I approach Carpal Tunnel Syndrome

when symptoms are just T you could feel things normally you can you know do buttons you can deal with like earrings and you know jewelry and small like coins that means that your sensation is normal and it’s really just more of a tingling burning type of symptom and that’s usually on the milder end of symptoms.

In those cases often times bracing at nighttime rest maybe some supplements there’s some literature that suggests that B vitamins can help but other than that I do often recommend a single cortisone injection that can help acutely decrease inflammation and pressure inside the carpal tunnel and it can make those symptoms often go away. Now sometimes that can cure it sometimes it comes back but we wait and see how you respond to that.

There is some studies that suggest shock wave can actually help carpal tunnel syndrome symptoms Again by addressing inflammation directly so that’s a series of three sessions of extracorporeal shock wave treatments and at the end of the road if your symptoms keep coming back then a carpal tunnel release likely will be a cure for your symptoms.

What is a Carpal Tunnel Release Procedure

what is carpal tunnel release procedure well I personally do one of two procedures I do both and it depends on the scenario but people who have more Progressive symptoms or more sever symptoms where not only are you feeling numbness burning maybe waking up at night with pain and that sort of median nerve distribution but also maybe you’re numb you literally can’t feel things you can’t discriminate between like this object or the textures between this maybe even you some might burn your fingers because your Sensations not protective that means you have much more severe symptoms.

In that case the nerve has been distressed for a very long time likely and I tend to do those carpal tunnel releases open. What that means is I make an incision in the palm kind of like right here in the middle of the base of your palm from about here to here and I go straight down. I go down to What’s called the transverse carpal ligament it’s the roof of the carpal tunnel and I simply release it and I also make sure that everything’s released around it and around the nerve that I can visualize.

Often times we’ll see it as like an hourglass configuration as it we can see right where it’s been squeezed and right away you can see blood flow kind of just open up a little bit around the nerve but it still may take time and I tell my patients who have open carpal tunnel release because they have severe symptoms when they’ve lost sensation your nerve pain related symptoms will go away almost immediately. The ability to feel if you’ve lost it can take many months and up to a year to get to your final result which isn’t even guaranteed to get you to normal it’s still worth it to go through the procedure because it will likely improve. So that’s when I use the open procedure.

Endoscopic Carpal Tunnel Release

now I also do endoscop carpal tunnel releases now what is that that’s by doing the procedure same idea we’re releasing the transverse carpal ligament underneath the skin but instead of doing it from the top down we are doing it through the bottom up.

So what I do is I introduce through a little incision still but smaller offset I do it in the Palm some will do it in the wrist crease but we get under the tunnel and then we look up with the scope we can see the the fibers Crossing above us making sure that there’s ‘s nothing in the way no nerve no tendon nothing and once we see those transverse fibers we can take a small blade and we release it from within.

And so by doing that that allows us to release the entire carpal tunnel without making a big open decision. Now the reality is doing it either way tends to be you know as long as you safely release the nerve and release the pressure on the transverse carpal ligament in the carpal tunnel your results will be great. The only difference that’s been ever really shown between endoscopic carpal tunnel releases and open carpal tunnel releases is a slightly decreased amount of paint early on in the first several weeks. After that the results tend to be the same.

So you know for milder symptoms I I will tend to suggest a endoscopic carpal tunnel smaller incision a little bit of a quicker healing process so that is my general approach to carpal tunnel syndrome if you have any comments or questions about the content you just watched in this video leave your questions below in the comments we’re here to help.