Carpal tunnel syndrome (CTS) is the most common cause of nerve compression in the arm. The carpal tunnel is about a 1-inch wide passageway where the median nerve and 9 tendons pass from the forearm into the hand. The compression is caused by increased pressure within the carpal tunnel, which decreases the blood flow to the nerve. When the median nerve is compressed it can result in pain, numbness, and weakness.
Most carpal tunnel cases are caused by a combination of factors. Repetitive hand use, hand and wrist positions during activities, health conditions, and even traits that run in your family can increase your chances of developing CTS. These situations can cause narrowing or swelling in the carpal tunnel. Pressure on the median nerve can also be caused by tenosynovitis, which is swelling in the lining of the flexor tendons. Some health conditions associated with carpal tunnel are thyroid conditions, rheumatoid arthritis, and diabetes.
In the early stages of carpal tunnel syndrome conservative treatments are used such as, anti-inflammatory medications (NSAIDs), splints, steroids, and therapy. These non-operate treatments can be effective early on or for mild symptoms, but as the compression becomes more severe and persistent they are less effective. Research has demonstrated an increased risk of permanent nerve damage with prolonged nerve compression. Therefore, earlier surgical intervention is often suggested if symptoms are severe and continue beyond 2 months. Traditional surgical treatment involves the open approach with a large incision and the endoscopic approach, which allows the surgeon to divide the thick tissue over the nerve through a minimal incision.
Dr. Fitzmaurice has developed the patent-pending EndoTech® nerve release system, the most advanced and safest treatment option for nerve compression syndromes. This unique system combines the benefits of an open technique-such as excellent visualization-with the significant improvement in recovery and minimal pain seen with endoscopic techniques. The EndoTech® nerve release allows for complete visualization of the entire band of tissue causing pressure, ensuring that a complete release can be performed. The surgeon can also see all the critical structures, such as the nerve, tendons, etc., so the procedure is performed in the safest way possible, significantly reducing any chance of recurrent or persistent symptoms requiring a second surgery. Patients can move the wrist immediately and often return to work within 1 week.
Studies have shown that this remarkable visualization significantly decreases surgical risks, with zero complications to date in over 4000 procedures performed. EndoTech® results in the least amount of pain and fastest recovery compared to other surgical techniques. This allows for a much higher success rate and a greater overall patient outcome.