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Treating Carpal Tunnel Syndrome

Carpal Tunnel Syndrome

As part of an initial non-operative treatment plan for carpal tunnel syndrome, your doctor may recommend activity modification. Recent research shows individuals who spend more time typing do not actually have a higher risk for carpal tunnel syndrome, and it might actually be lower. However, proper posture when sitting at a desk for long periods is essential.

In terms of carpal tunnel, wrists should be just slightly extended while typing; the palm of the hand and forearm should not be leaning on anything, as this puts additional pressure on the nerve. Wearing a light wrist splint or guard while you type can help train you to keep your wrists in this "neutral" position.

Wrist splints also can be helpful and are the main non-operative treatment, particularly if you are having symptoms at night. This can prevent you from bending your wrists while you sleep. For many people, this can eliminate early nighttime CTS. Your doctor might recommend corticosteroid injection to decrease inflammation around the nerve. In some instances-particularly for women who develop CTS during pregnancy-this can treat symptoms. More commonly, these injections are used to assist your hand surgeon in making an accurate diagnosis. 

Surgery and other Treatments

Surgical intervention is another treatment option for carpal tunnel. A hand surgeon may release the carpal tunnel by cutting the ligament compressing the nerve to enlarge the tunnel and decrease nerve pressure.

Ultrasound Guided Carpal Tunnel Release (USG-CTR) with Sonex Carpal tunnel release device

A newer treatment option being offered is Ultrasound Guided Carpal Tunnel Release. USG-CTR is an ultra-minimally invasive technique for the treatment of carpal tunnel syndrome. The procedure is typically performed in a doctor’s office using only local anesthetic and ultrasound guidance, making the procedure extremely safe. This technique allows patients to return to normal activity and work much faster than traditional carpal tunnel release surgery (2-3 days versus 2-3 weeks).

Instead of a small incision, an instrument is introduced through a small skin puncture (2-3mm). The surgical device is then advanced into the carpal tunnel using ultrasound guidance. Safety guards are then inflated and the carpal tunnel ligament is transected by a small cutting blade. The device is then removed and a small bandage is used to close the skin. Patients go home shortly after the procedure and can perform light activity the same day.

After Surgery

A bulky gauze dressing secured with ACE wraps will be around your hand and wrist. Keep your hand at the level of your heart to keep the swelling down. To make sure the swelling does not cause your bandage to decrease your blood flow to your hand, watch your fingers to make sure they are warm to touch and when squeezed, they go from white back to pink in color. Additional information about what precautions and safety measures you may need to take will be given by your doctor.

Recovery from carpal tunnel release surgery can last from a few weeks to a few months, during which a patient may feel soreness in the palm. The rate at which numbness and tingling disappear varies from patient to patient, but night symptoms usually resolve first. Hand and wrist strength may take a few months to be fully restored. Unfortunately, if there has been very severe or prolonged compression, even surgery might not fully relieve all symptoms.