Carpal Tunnel Syndrome

Carpal Tunnel Syndrome

What is Carpal Tunnel Syndrome?

A pinched nerve in the wrist. There is a tunnel (the carpal tunnel) in the wrist where the median nerve and nine tendons pass through. The nerve is pinched when swelling in tunnel puts pressure on the nerve. (See Carpal tunnel anatomy photo). It affects 1/20 people.

What cause Carpal Tunnel Syndrome?

  • Swelling of the tendons
  • Wrist fractures
  • Arthritis
  • Swelling related to pregnancy

Common Symptoms

  • Pain
  • Numbness of the thumb, index, middle and half of the ring finger
  • Tingling of the finger
  • Clumsiness of the hand
  • Waking up in the middle of the night needing to shake your hand

Diagnosis

  • See your Hand Surgeon
  • Clinical exam
  • May need a special test called the EMG or electrodiagnostic study.

Treatment

  • Splinting: for new and mild cases
  • Steroid injection: usually reserved for pregnant women, and atypical presentation to help confirm diagnosis (20%-30% long term success)
  • Surgery:  for moderate to severe cases, especially patients with weakness.

Open vs Endoscopic Carpal Tunnel Release Surgery

  • Long-term outcome is the same based on many studies.
  • If clinically indicated, Dr. Zhang prefers the endoscopic approach.  In his experience, his patients on average experience faster recovery after endoscopic carpal tunnel release.

See the video of Dr. Zhang performing an endoscopic carpal tunnel release. (See Video: Dr. Zhang performing endoscopic carpal tunnel release)

Before the after photos of the incision (See Endoscopic carpal tunnel release incision before and after)