Carpal Tunnel Syndrome

University of Iowa Health Care orthopedic surgeons offer the full range of carpal tunnel treatment options, including physical therapy, wrist splints, and carpal tunnel surgery.

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If your symptoms are severe or nonsurgical treatments don’t help, your provider may recommend surgery.

The standard surgical treatment for carpal tunnel syndrome is called “carpal tunnel release surgery.” During the procedure, your surgeon makes an opening in the ligament that covers your carpal tunnel, so that it no longer compresses the median nerve.

There’s no harm in cutting into this ligament; it won’t affect your hand or wrist function. In fact, for many people, carpal tunnel surgery provides immediate and permanent relief.

Orthopedic surgeons from UI Health Care offer the open carpal tunnel release. With this approach, your surgeon makes a two-inch incision on your palm. Next, they perform the surgery using traditional surgical tools. This is usually the preferred technique for people who have had previous carpal tunnel surgery or broken hand or wrist bones.

This type of carpal tunnel release surgery can be performed on an outpatient basis, meaning you can return home the same day. And no matter which procedure you have, you can request local anesthesia (meaning you’re awake but comfortable).

Carpal tunnel syndrome causes and symptoms

Carpal tunnel syndrome can affect anyone, especially people over age 30. However, it usually occurs in people who frequently use their wrists, hands, and fingers.

What causes carpal tunnel syndrome?

Carpal tunnel syndrome is one of many conditions caused by a compressed nerve.

Your “carpal tunnel” is a narrow opening (tunnel) inside your wrist. This space contains the median nerve, which allows your forearm, wrist, and hand to move and feel things. It’s also covered by a strong band of tissue called a ligament.

If your ligament becomes inflamed (swollen) because of an injury or overuse, it can press against your median nerve. This pressure can affect sensation and movement in your hand and wrist.

Carpal tunnel symptoms

For many people, an early sign of carpal tunnel syndrome is hand numbness or tingling during the night. These sensations may be strong enough to wake you up.

Other symptoms, which can occur at any time of day or night, include:

Numbness or loss of sensation in your fingertips
Numbness or tingling in your palm
Pain or tingling in your fingers (especially your thumb, index finger, and middle finger)
Pain that starts in your hand and radiates down your forearm
Reduced dexterity in your hand and fingers
Difficulty holding or gripping objects

Carpal tunnel symptoms usually come on gradually and get worse over time. Without prompt diagnosis and treatment, you may eventually even have a hard time using your hands for everyday tasks.

Carpal tunnel syndrome diagnosis

If you or your provider suspect you have carpal tunnel syndrome, turn to UI Health Care.

We offer all the tests you might need to diagnose carpal tunnel and rule out other conditions that can cause the same symptoms. These conditions include spinal stenosis, Charcot-Marie-Tooth disease, and thoracic outlet syndrome.

To that end, you may have one or more of the following:

A physical examination to see if certain hand and wrist movements cause you to feel numbness or tingling
Hand function tests to assess your grip, dexterity, and other measures of hand strength and function
An ultrasound to determine if your median nerve is compressed
An electromyogram (EMG) and nerve conduction study to measure how well your hand and wrist muscles respond to nerve stimulation

Because we offer in-office ultrasound, we can usually look at your carpal tunnel and median nerve the same day as your physical exam. This helps us make a diagnosis more quickly and reduces the number of trips you need to make to our campus.

Carpal tunnel treatment from UI Health Care

With prompt diagnosis and treatment from experienced orthopedic specialists—like those from UI Health Care—carpal tunnel syndrome is highly treatable.

Nonsurgical treatments for carpal tunnel syndrome

Many people with carpal tunnel can reduce or relieve their symptoms with nonsurgical treatments. These include:

Wrist splints

These wearable devices hold your wrist in a straight position, which takes pressure off your median nerve. Wearing a wrist splint at night keeps you from curling or bending your wrist while asleep and prevents your symptoms from flaring up.

Medicine

Anti-inflammatory medicines (like ibuprofen) and injectable steroid medicines can reduce pain and inflammation.

Physical therapy

Our physical therapists can teach you hand and wrist exercises and positioning techniques. You’ll learn how to avoid putting pressure on your median nerve, which can reduce your symptoms. These exercises can also help you improve wrist and hand strength and function.

Carpal tunnel surgery

If your symptoms are severe or nonsurgical treatments don’t help, your provider may recommend surgery.

There’s no harm in cutting into this ligament; it won’t affect your hand or wrist function. In fact, for many people, carpal tunnel surgery provides immediate and permanent relief.

Orthopedic surgeons from UI Health Care offer two types of carpal tunnel release surgery:

Open carpal tunnel release: With this approach, your surgeon makes a two-inch incision on your palm. Next, they perform the surgery using traditional surgical tools. This is usually the preferred technique for people who have had previous carpal tunnel surgery or broken hand or wrist bones.
Endoscopic carpal tunnel release: During this minimally invasive approach, your surgeon makes a half-inch incision on your wrist. Next, they gently guide a small tube (endoscope) mounted with a camera through one of the incisions. When the endoscope reaches your wrist, your surgeon can use the device to cut your ligament.

Both types of carpal tunnel release surgery can be performed on an outpatient basis, meaning you can return home the same day. And no matter which procedure you have, you can request local anesthesia (meaning you’re awake but comfortable).

You and your orthopedic surgeon will decide which approach is best for you based on several factors. These include your hand and wrist anatomy and your personal goals and preferences.