Carpal Tunnel Syndrome

Carpal tunnel syndrome occurs when the median nerve becomes compressed in the carpal canal, producing numbness, pain and weakness in the fingers and hand. Nerve conduction testing can determine the presence and severity of carpal tunnel syndrome and help distinguish it from other conditions. Various non-surgical or surgical treatments may be appropriate for treatment of carpal tunnel syndrome. If untreated, carpal tunnel syndrome may lead to more permanent nerve damage. Depending on the severity of carpal tunnel syndrome, different treatments may be appropriate.

Bracing, activity modification, injections and non-steroidal anti-inflammatory medications may be indicated to reduce symptoms of carpal tunnel syndrome. If nerve damage is present based on EMG testing, surgical treatment may be indicated.

Surgical treatment of carpal tunnel syndrome involves cutting the transverse carpal ligament to widen the carpal canal and take pressure off the median nerve. Carpal tunnel release can be performed with either an open or endoscopic technique.

Open carpal tunnel release involves cutting all the tissue layers of the palm including the epidermis, dermis, fat, palmar fascia and palmaris brevis to expose and then cut the transverse carpal ligament.

Endoscopic carpal tunnel surgery is designed to cut only the transverse carpal ligament and leave intact the top 4 layers of palmar tissue. In selected patients, endoscopic carpal tunnel release may produce much less local tissue trauma, pain, swelling and facilitate faster return to more normal activities. Endoscopic carpal tunnel release can often be performed with a single stitch and a 1 cm. incision.