Nerve Conditions · Hand & Wrist
Endoscopic Carpal Tunnel Release
Minimally Invasive
Endoscopic carpal tunnel release is a minimally invasive surgery that relieves numbness and tingling caused by median nerve compression at the wrist — the same condition known as carpal tunnel syndrome. The small-incision technique preserves the overlying tissue and gets patients back to light activity sooner than a traditional open release.
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Overview
What Is Carpal Tunnel Syndrome?
Carpal tunnel syndrome is a common compressive neuropathy that affects the hand. The median nerve travels through a narrow passage at the wrist called the carpal tunnel, alongside the tendons that bend your fingers. When that passage narrows or the tissue around it thickens, the nerve is compressed — and the result is numbness, tingling and sometimes weakness in the parts of the hand the median nerve supplies.
Patients often have symptoms of numbness and tingling which may affect the thumb, index, middle, and/or a portion of the ring finger. The discomfort associated with this condition may cause nighttime symptoms which interfere with sleep. In severe cases, weakness of muscles that move the thumb may occur. Individuals may also be unable to perform extended activities which involve repetitive wrist motion without discomfort.
Because the symptoms can overlap with other nerve conditions, an evaluation helps confirm what is actually causing your symptoms and guide the right treatment. If you are noticing numbness in these fingers, our patient education article on the early signs of carpal tunnel syndrome is a good place to start understanding what you are feeling.
Common Symptoms
- Numbness and tingling in the thumb, index, middle and/or part of the ring finger
- Nighttime symptoms that interfere with sleep
- A feeling that the hand has “gone to sleep” or needs to be shaken out
- Discomfort with extended activities involving repetitive wrist motion
- Weakness of the muscles that move the thumb in severe cases
- Dropping objects or difficulty with fine tasks such as buttoning clothing
When to Seek Evaluation
Symptoms that persist, worsen at night, affect your sleep, or begin to cause weakness or dropping objects are worth evaluating. An examination can help determine whether the median nerve is involved and what treatment is likely to help.
Request an AppointmentTreatment Options
Non-Surgical Treatment
Many patients improve with conservative treatment, especially when symptoms are mild or intermittent. Non-surgical options include splinting, cortisone injection, and activity modification.
Night Splinting
Wearing a splint at night that positions the wrist in neutral may help prevent tension on the median nerve while sleeping. This may improve symptoms — particularly the nighttime numbness and tingling that disrupt sleep.
Cortisone Injection
A cortisone injection into the carpal tunnel can reduce inflammation around the median nerve and relieve symptoms. Injections may provide meaningful relief and are sometimes used to help confirm the diagnosis.
Activity Modification
Modifying activities that involve prolonged or repetitive wrist motion may reduce irritation of the nerve. Avoiding sustained extreme wrist positions — especially during sleep — is often part of the plan.
Non-operative treatment also carries risks and benefits which should be discussed with your treating physician.
Surgical Treatment
Carpal Tunnel Release
Surgical options include endoscopic (“minimally invasive”) and open carpal tunnel release.
Carpal tunnel release surgery is performed in many ways. Options include making an incision in the palm of the hand to release the underlying transverse carpal ligament which is compressing the median nerve.
During release, many variations in anatomy may be encountered: accessory muscles, split or bifid median nerves, and/or a persistent artery from embryonic development. An understanding of these possible variations is part of the surgical planning.
Release of pressure from the transverse carpal ligament may allow for improved blood flow to the nerve and potential recovery and improvement in symptoms. Outcomes after surgery vary, and risks and benefits should be discussed in detail with your treating physician.
Discussing Risks & Benefits
Every treatment — surgical or non-surgical — carries its own risks and potential benefits. The right choice depends on your symptoms, examination findings, severity and goals. Dr. Amin reviews these with you in detail so you can make an informed decision about your care.
Anatomic Variations Encountered
- Accessory muscles within the carpal tunnel
- Split or bifid median nerves
- A persistent artery from embryonic development
Considering Carpal Tunnel Release?
An evaluation can confirm the diagnosis, assess severity and help determine whether surgery or continued non-surgical care is the better path for you.
Request an AppointmentCommon Questions
Carpal Tunnel Syndrome FAQs
What are the symptoms of carpal tunnel syndrome?+
The most common symptoms are numbness and tingling affecting the thumb, index, middle, and/or a portion of the ring finger. Symptoms often worsen at night and may interfere with sleep. In more severe cases, weakness of the muscles that move the thumb may occur, and extended activities involving repetitive wrist motion may become uncomfortable.
Can carpal tunnel syndrome be treated without surgery?+
Yes. Non-surgical treatment options include splinting, cortisone injection, and activity modification. Wearing a splint at night that positions the wrist in neutral may help prevent tension on the median nerve while sleeping, which may improve symptoms. Non-operative treatment also carries risks and benefits which should be discussed with your treating physician.
What does carpal tunnel release surgery involve?+
Carpal tunnel release surgery is performed in many ways. Options include making an incision in the palm of the hand to release the underlying transverse carpal ligament which is compressing the median nerve. Release of pressure from the ligament may allow for improved blood flow to the nerve and potential recovery and improvement in symptoms.
Will carpal tunnel surgery definitely resolve my symptoms?+
Outcomes after surgery vary. Risks and benefits should be discussed in detail with your treating physician. An evaluation can help determine whether surgery or continued non-surgical care is likely to be the better option for your situation.
For more on distinguishing nerve conditions, read Cubital Tunnel vs. Carpal Tunnel or explore wrist arthroscopy.
Precision Hand and Orthopedic Surgery
Numbness or Tingling in Your Hands?
If numbness, tingling or weakness in your hand is affecting your sleep or daily activities, an evaluation with Tanay Amin, MD, FAAOS can help determine whether carpal tunnel syndrome is the cause and what treatment is right for you.
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Disclaimer: This information is not intended to convey, substitute or supplant any medical advice. In order to establish a treating relationship, please schedule and complete your visits with a licensed physician.
Copyright 12/9/2021 Tanay Amin, MD. Do not copy, distribute, or publish this article. Please contact Precision Hand and Orthopedic Surgery PLLC with regards to any inquiries or corrections.