Written by: Paul A. Cook, MD
Have you ever experienced pins and needles in your fingers? Has this awakened you at nighttime? In medical terms, you have experienced nocturnal paresthesia caused by pinching or compression a major nerve at your wrist: the median nerve. The common term or diagnosis is carpal tunnel syndrome (CTS). When the median nerve is pinched or compressed tingling occurs in your thumb, index finger, middle finger and part of your ring finger. As the problem advances, pins and needles and loss of strength and coordination may develop.
Recurrence of the above symptoms requires the evaluation of fellowship trained hand and microsurgeon. The initial recommendation may be electrophysiological testing or EMG/NCV. This test will confirm the clinical diagnosis. Recommended treatment may vary from continue conservative measures (observation, bracing, steroid injection) to surgical intervention. The most common reason to recommend surgical intervention are persistent abnormal sensation and weakness in conjunction with a EMG/NCV that confirms the diagnosis of CTS.
Several methods of surgical intervention are available to successfully treat CTS. The goal of surgical intervention is to resolve nocturnal paresthesia or night pain and numbness. The additional benefit of surgery is to prevent further damage to your nerve and the hope or nerve recovery. Unfortunately, return of sensation and strength is variable to each patient and related to amount and duration of compression and any underlying medical problems.
The technique of surgery is dependent upon surgeon’s preference. Although the long-term results of open (classic) and endoscopic (contemporary or new) are equivalent by 12 weeks, the endoscopic technique is associated with less initial pain, less surgical trauma, earlier return to activity, and almost no need for post-operative therapy.
When discussing treatment, make sure you understand the diagnosis, the severity of your CTS and the surgical procedure that fits your lifestyle.
We’re the only group of specially trained hand surgeons in Central Ohio who provide on-call emergency care, 365 days a year.
Our on-site surgery and therapy centers allow us to provide patients with comprehensive, advanced treatment in one convenient location.
While we strive to keep your primary care physician informed of the care you receive, we are happy to see you without a referral.