CARPAL TUNNEL SYNDROME (CTS)

The carpal tunnel is the small passageway in the wrist containing the ligament, nerve and tendons connecting the fingers to the muscles of the forearm.

Carpal tunnel syndrome (CTS) is one of the most commonly reported occupational health problems. It occurs when the median nerve becomes pinched due to swelling. This nerve provides sensation to the palm side of the thumb, index finger, middle finger and to the inside half of the ring finger. When pinched, the result can be a combination of tingling, numbness, weakness and pain. This occurs in the fingers, thumb, palm or the forearm. If the condition is not treated, permanent deterioration of muscle tissue can occur.

CTS is caused by conditions or activities that put pressure on the median nerve and decrease its blood supply. This is most commonly due to forceful or repetitive movement of the fingers and hand, especially if the wrist is in an awkward position. The best example of this is typing.

A diagnosis will be based on an evaluation of your medical history, physical exam and, occasionally, further tests. When patients are unable to get relief from their CTS symptoms by non-surgical means, tests may indicate that nerve damage and/or growths need to be removed. The goal of surgery is to reduce the pressure on the median nerve in the wrist and involves endoscopically cutting the transverse carpal ligament to relieve that pressure. The surgery is typically done under regional or general anesthetic on an outpatient basis.

See video clips of endoscopic carpal tunnel surgery below.

Video 1

Video 2

Video 3