Dr. Benjamin Berenfeld Heals Major Carpal Tunnel Pain with Minor Surgery

Dr. Benjamin Berenfeld

By Dr. Benjamin Berenfeld

Some of the most common complaints that patients come to me with are pain and numbness in the hand, which is frequently diagnosed as carpal tunnel syndrome. Previously believed to be caused by overuse of the hand by typing or writing, now it has been shown to have no association with these activities. Precise causes of this syndrome remain largely unknown. It is commonly found in people with diabetes and more often found in women, although men are also affected.

Carpal tunnel syndrome is caused by an increased pressure on one of the major nerves of the hand. This type of nerve compression is responsible for loss of sensation in the hand and loss of certain muscle control. Common symptoms of nerve compression include numbness, tingling, burning, pain in the fingers and palm. People with carpal tunnel syndrome often shake their hand to stop the numbness and pain.

So, how is carpal tunnel syndrome treated?

Evaluation and treatment by a hand surgeon is recommended early in the process. Initially, I may recommend conservative treatment, which includes cortisone injections into the carpal tunnel, application of wrist braces for nighttime use and occasional brief course of non-steroidal anti-inflammatory medication. If the symptoms do not improve, a surgical release of the carpal tunnel is recommended. If the condition is allowed to progress for a long period of time, the compressed nerve undergoes irreversible changes that may not be helped even with a surgical release.

The traditional surgery for carpal tunnel release involves making a 2.5 inch incision along the midline of the wrist, fully opening the carpal tunnel. Most hand surgeons perform the release through a 1.5 inch incision. In recent years, some hand surgeons, including myself, who are trained in wrist endoscopy, have been using a minimally invasive technique, called endoscopic carpal tunnel release. I perform this surgery through a 1/2 inch incision at the wrist crease, into which a camera is placed, eliminating the need for a long wound and therefore leaving minimal scaring.

What is a typical recovery after the endoscopic carpal tunnel release?

Endoscopic release is a great option with excellent functional and cosmetic results, leaving an invisible scar after a few months. The procedure takes about 15 minutes (including sedation time) and is performed in an ambulatory setting under mild sedation and local anesthetic. It lets patients return to normal activities much faster than the traditional open approach. Frequently, the pain and numbness disappear immediately after the surgery, and the hand can be used right after the procedure. My patients return to office type work on day 3 or 4 after the surgery and to manual labor by week 3, without requiring any therapy.

If you have questions or need a consultation about problems in your hands, as well as wrist, elbow and shoulder conditions, fell free to contact me at Specialty Orthopedics in Harrison, New York, phone: (914) 686-0111 or http://specialtyorthony.com

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Last updated by Margarita at October 19, 2010.

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