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Carpal tunnel syndrome usually begins with symptoms of numbness, tingling, or burning in one or both hands. Some patients wake up at nighttime with pins and needles in their fingers, others may feel their hands fall asleep when they are driving, and some may feel sudden jolts of “electricity” in the hand when doing heavy labor. Carpal tunnel syndrome can present with a wide array of symptoms, but it is a very common issue. Generally, the disease process starts gradually beginning with intermittent symptoms that may become more frequent over time.

Once the disease process has progressed, patients may notice difficulty with fine motor skills such as buttoning a shirt or picking up coins. Addressing carpal tunnel syndrome at or near its onset is most beneficial and will help ensure no permanent loss of muscle or sensation. There are several different treatment options that we will discuss in further detail, but first, we want you to gain a simple understanding of the disease process.

What Is Carpal Tunnel Syndrome?
Carpal tunnel syndrome is a compression of the median nerve at the wrist level. The median nerve is a long nerve that runs down your arm and into your hand. It is in charge of sensation in the hand as well as different motor functions. The carpal bones are bones in the hand that create a crescent that many tendons and your median nerve run through. The transverse carpal ligament creates a roof for the crescent and encloses the tendons and median nerve.
During carpal tunnel syndrome the pressure within this fixed space increases and begins to compress the median nerve. This pressure increase can be due to overuse, inflammation of the tendons, trauma, or other factors. The median nerve is very sensitive to these pressure changes and when compressed may cause weakness, numbness, and tingling into your hand. If compressed for long periods you may develop muscle atrophy and damage that is difficult to reverse. It is important to have your carpal tunnel syndrome evaluated to determine its severity and your best course of treatment.

How Do I Know If I Have Carpal Tunnel Syndrome?
Carpal tunnel syndrome can be diagnosed through careful examination and special tests that our doctors will perform in our office. Depending on the severity of your symptoms, our doctors may order nerve studies from a neurologist to help delineate the extent of nerve compression and damage, although this is not always necessary.

Treatment for mild carpal tunnel syndrome may start conservatively. Wearing supportive wrist braces at night is often an initial step. This will help keep your wrists in a neutral position, avoiding wrist flexion and further compression of the nerve. A corticosteroid injection may also be offered to help alleviate inflammation and symptoms. Operative treatment may be offered if you have a moderate or severe case of nerve compression or if conservative treatments have been exhausted and your symptoms persist.

Carpal Tunnel Release Surgery
Carpal tunnel release surgery may be done as an open procedure or endoscopically. The endoscopic carpal tunnel release involves making a small 1.5cm incision in the palm or the distal wrist crease and introducing a small endoscopic camera under the transverse carpal ligament.

The transverse carpal ligament (the roof of the tunnel) is cut across its entire length with a special blade that is attached to the camera. An open carpal tunnel release is done through a slightly larger incision. In this case, the transverse carpal ligament is cut through direct visualization.

Carpal Tunnel Syndrome Surgery
Either way, this allows the tunnel to open up and decompresses the median nerve. It is important to note that cutting this ligament will not cause any loss of strength or function.

Carpal Tunnel Syndrome Surgery Recovery
The camera allows your doctor to visualize the entire carpal tunnel through a small incision. The transverse carpal ligament (the roof of the tunnel) is cut across its entire length with a special blade that is attached to the camera. An open carpal tunnel release is done through a slightly larger incision. In this case, the transverse carpal ligament is cut through direct visualization. Either way, this allows the tunnel to open up and decompresses the median nerve. It is important to note that cutting this ligament will not cause any loss of strength or function.