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New Jersey’s Carpal Tunnel Syndrome Surgery Experts

What is carpal tunnel syndrome?

Carpal tunnel syndrome is an extremely common condition where one of the major nerves of the hand becomes compressed in a small tunnel at the wrist. Essentially, it is a pinched nerve at the wrist level, which can result in numbness, tingling, and pain.

The carpal tunnel is an enclosed space within the wrist where nine tendons run adjacent to the median nerve. With limited space for all of these different residents of the tunnel, the nerve can easily become compressed. At The Center for Hand & Upper Extremity Surgery, our orthopedic surgeons specialize in carpal tunnel syndrome surgery, which can provide significant relief from pain.

What causes carpal tunnel syndrome?

Although there have been many theories for why carpal tunnel syndrome occurs (related to work, repetitive activities, specific motions, etc.), the reality is that the true cause is usually unknown. Generally speaking, it is an issue of space – when the nerve does not have enough space, it can become compressed, and this can, in turn, cause symptoms. Other ways that the nerve can become compressed include:

What are the symptoms of carpal tunnel syndrome?

Carpal tunnel syndrome symptoms may be mild at first, eventually progressing as the condition advances. Symptoms may include:

The main symptom that indicates carpal tunnel syndrome is numbness or tingling of the first three and a half fingers of the hand (thumb, index, middle, and half of the ring). Tingling is often worse at night or first thing in the morning. It may be provoked by activities that involve gripping an object, such as a cell phone or newspaper.

Patients may be awoken in the middle of the night by “night pain”, and may feel the need to “shake out their hand” to improve symptoms. In the early stages of carpal tunnel syndrome, tingling will be temporary and eventually return to normal. If the condition gets worse, the sensation may become continuous. Patients often describe feeling clumsy and dropping objects easily. In severe cases, the muscles at the base of the thumb may irreversibly waste away.

carpal tunnel syndrome graphic

How is carpal tunnel syndrome diagnosed?

The diagnosis of carpal tunnel syndrome is generally made on physical examination. Your doctor will perform numerous physical exam maneuvers, and combined with the story of your injury, will determine if carpal tunnel syndrome is suspected.

Carpal tunnel tests — such as a nerve conduction study and electromyography — can help confirm the diagnosis. Additional testing, such as an ultrasound or x-ray, may also be required to help diagnose the injury.

What surgical treatments are available for carpal tunnel syndrome?

The goal of treating carpal tunnel syndrome is to improve the feelings of numbness, tingling, and pain while also ensuring the disease process does not progress to cause irreversible damage to the median nerve. At The Center for Hand & Upper Extremity Surgery, we use an algorithmic approach to treating this very common problem. Our treatment options for carpal tunnel syndrome include:

Depending on how severe your case is, your doctor may start with non-operative measures to improve your symptoms. This will include changing the patterns of how you use and position your hand, as well as splinting to reduce pressure on the nerve. Next, a steroid injection may be administered in an attempt to help reduce swelling and inflammation around the nerve.

If your symptoms continue, or if you have a severe case, we may pursue carpal tunnel syndrome surgery to decompress the nerve. We use either a minimally invasive technique called “endoscopic carpal tunnel release” or a more traditional open carpal tunnel release. The endoscopic procedure is used to prevent a large scar on your palm and to improve your recovery.

Our belief, as supported by literature, is that early recovery is much more comfortable for the patient, and the scar burden is much less using the endoscopic approach. The procedure involves a very small transverse incision on your wrist and the introduction of cameras to see on the inside of your hand. Your surgeon will then use a specialized internal blade to cut the “transverse carpal ligament” to release the pressure on the median nerve. There are situations where the more traditional open carpal tunnel release is indicated – your surgeon will discuss the pros and cons of carpal tunnel surgery to help you determine which surgery is more appropriate for you.

Will I need therapy after carpal tunnel syndrome surgery?

Most patients do not require formal hand therapy after carpal tunnel release. Motion is started immediately after surgery, and stiffness is uncommon.

Carpal tunnel surgery recovery time varies for each person and may be dependent on how long you’ve had nerve compression.

There are no specific restrictions after carpal tunnel surgery, but you may need to adjust certain home or work activities while you recover. Your doctor will provide more information after your surgery.

Carpal Tunnel vs. Arthritis

Experiencing pain or stiffness in the hands or fingers can cause difficulties for many patients. You may wonder whether the pain is a result of carpal tunnel syndrome or arthritis. While both conditions can cause hand pain, they generally affect different parts of the hand and have different causes.

Carpal tunnel syndrome is a nerve disorder, while arthritis results from inflammation of the joints. The pain and numbness that occurs with carpal tunnel affects your thumb, index finger, middle finger, and part of your ring finger, while arthritis causes pain in the wrist, knuckles, and finger joints.

Some symptoms, such as weakness or inability to grab objects, may overlap, but the mechanisms for why this occurs with each condition are different. Due to these differences, treatment approaches can vary. Both arthritis and carpal tunnel syndrome respond well to anti-inflammatory medications. Surgery is a treatment option for severe cases. For arthritis, our orthopedic surgeons perform a minimally invasive procedure known as joint denervation surgery. Patients with carpal tunnel syndrome, on the other hand, benefit from surgical procedures including endoscopic carpal tunnel release or traditional open carpal tunnel release.

Carpal Tunnel Syndrome Surgeons Near Me

The orthopedic surgeons at The Center for Hand & Upper Extremity Surgery have extensive experience and training for a variety of hand and wrist surgeries. Discover relief from the pain of carpal tunnel syndrome with advanced treatment from our experienced surgeons.

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Are you experiencing symptoms of carpal tunnel syndrome and exploring how to alleviate your discomfort? We can help — schedule your appointment today.


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