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Home > Services > Ultrasound Guided Musculoskeletal Interventions > Carpal Tunnel

What is Carpal Tunnel Syndrome(CTS)?
CTS occurs when the median nerve, which runs from the forearm into the hand, becomes compressed by the transverse carpal ligament at the wrist. The result is pain, weakness, and numbness in the hand, occasionally radiating up the arm.  Symptoms start gradually involving the thumb, index, and middle fingers appearing during the night initially, and as the condition worsens they are also felt during the day.

What are the standard treatments for Carpal Tunnel Syndrome?
Rest, splinting, cold packs, and anti-inflammatory medicines are all initial treatments for CTS.  A cortisone injection may provide temporary relief, but many CTS suffers require surgical decompression of the affected nerve.

What is an Ultrasound-Guided Percutaneous Release of the Carpal Tunnel?
While surgery involves severing the transverse carpal ligament compressing the nerve,  a percutaneous release involves using a needle to repeatedly perforate this ligament to relieve the pressure on the nerve.  A combination of lidocaine and saline is also injected around the nerve to “hydro-dissect” it from the overlying ligament.

 

What should I expect after the procedure?
The procedure is done in the office with local anesthetic.  It takes approximately 30 minutes.  After an initial injection of anesthetic, it is painless.  The hand is quite numb for a few hours after the procedure, but all activities may be resumed the following day.  It is not necessary that you be off of work for any length of time.

How effective is this treatment?
This procedure is very new, so there is limited data regarding the long term outcome.  Most patients feel improvement within a few days.  If the nerve has been severely pinched, the recovery takes longer. A recent study of 44 wrists, showed a failure of only 5 patients in the 18 months following the procedure.1 Those failing the procedure were then referred for surgery.

What are the possible side effects of the procedure?
As with any procedure there is a small risk of bleeding and infection.  Because the needle release is done directly over the nerve, there is a small risk of injury to the median nerve as well.


1 Malone D, Clark T, Wei N. Ultrasound-Guided Percutaneous Injection, Hydrodissection, and Fenestration for Carpal Tunnel Syndrome. The Journal of Applied Research, vol.10, No. 3, 2010