Ask the MSK Expert: I have Carpal Tunnel Syndrome; now what?


Dr. Pacek says: Carpal Tunnel Syndrome (CTS), the most common nerve compression problem in the hand and arm, occurs when the median nerve is compressed or pinched at the carpal tunnel in the wrist. Its cause is unknown, but a common misconception is that office or computer work causes CTS. Symptoms include numbness, tingling, and pain in the thumb, index and middle fingers, although it may feel like the entire hand is affected.

Once diagnosed with CTS, the typical initial treatment includes nonoperative conservative care such as resting the affected hand and wrist; modifying how you use your hand to avoid activities that lead to symptoms; ice and heat; medications; night splinting; injections; and physical therapy. Your medical provider may also order a nerve conduction study to better evaluate your condition and determine the severity of the disease.

When CTS cannot be resolved with conservative treatment alone, carpal tunnel release surgery may be an option. During surgery, the tight ligament that forms the roof of the carpal tunnel is cut, or “released” to remove the pressure on the median nerve. My Tri Rivers colleagues and I prefer performing the less invasive version of this surgery – an endoscopic carpal tunnel release – where a small device with a camera is placed into the carpal tunnel and a very small surgical blade is used to cut the transverse carpal ligament. This procedure creates more room for the median nerve to pass through the wrist. Patients who undergo endoscopic surgery often have less pain and an earlier return to work and hand function compared to open surgery.

For most people, carpal tunnel release surgery provides permanent relief from symptoms. Recovery from surgery is quick, with most patients returning to their normal activities within a few weeks.

Physician Spotlight
Corey A. Pacek, MD, is a fellowship-trained hand and upper extremity surgeon at Tri Rivers. He treats conditions including arthritis of the hand, wrist and elbow; carpal tunnel syndrome; tendonitis; fractures; dislocations; and ligament and tendon injuries.

Dr. Pacek sees patients in our BHS Crossroads Campus and Slippery Rock offices. To schedule an appointment with him, or any other Tri Rivers provider, please call 1-866-874-7483 or click here.