Carpal Tunnel

Carpal tunnel syndrome typically involves compression of the median nerve typically at the wrist. By entrapment of the median nerve can occur elsewhere along the course of this anatomic structure the most common site that produces classic numbness and tingling into the radial 3 fingers is entrapment at the wrist.

There is a host of reasons both anatomically and environmentally that can produce carpal tunnel syndrome. This disorder can also be age-related. As we age, the volar carpal retinaculum becomes thickened, oftentimes compressing the median nerve. This, in conjunction with lifelong repetitive activity, can cause a thickening of this ligament, thereby producing compression along the median nerve as it enters into the wrist. This neurologic structure, the median nerve, has multiple variations with respect to its motor branch that innervates the muscles of the thumb that the surgeon must be cautious of during surgery. Typically, carpal tunnel can be managed nonsurgically with night splints, corticosteroid injections, platelet rich plasma, nonsteroidal medications and rest from any precipitating activity that is repetitive in nature.

While we obviously know much about this condition, patients often present in myriad ways. We have seen several instances of patients in our practice who have had significant neck and shoulder pain with only mild numbness and tingling in the wrist and hand which has resolved with a successful carpal tunnel surgery. This is probably a result of the electrical circuit nature of our neurologic system. In other words, radiating pain back up the circuit in the shoulder and neck region could be simply related to carpal tunnel entrapment.

Typically before surgery and electromyelogram from a board certified physiatry or neurologist is typically recommended. This study allows us to determine the side of nerve entrapment and whether there is any other issues such as neuropathy from diabetes or some other disorder.

The results of carpal tunnel surgery are generally outstanding. Patients are very gratified . Recovery is very quick and many of the vague painful symptoms associated with neck and shoulder pain resolve very quickly with a carpal tunnel release. Surgery is typically done with light sedation and always on an outpatient basis. Despite the high success rate of this simple procedure it should be approached with a very thorough workup to make sure that entrapment at the carpal canal of the wrist is the offending area. Even though the surgery by most standards is very straightforward and done on an outpatient basis the operating physician must be in tune to all the anatomic variance of this very special nerve.

5491 Far Hills Ave

Dayton OH 45429

OUR SPECIALTIES

 

Since 1993, Dayton Orthopedic Surgery has been dedicated to delivering the gold-standard for Orthopedic care in the Miami Valley. With over 60 years’ combined experience, our expert staff treats a wide range of bone and joint dysfunctions caused by trauma, sports injuries and degenerative conditions.  

From initial diagnosis all the way through to physical therapy, Dayton Orthopedic Surgery is devoted to getting you back to you again.

Happy Patients

“Listened & understood my needs before surgery. The surgery went very well, and was just as he explained. Post surgery recovery time was much less than expected. Absolutely no pain, very minimal discomfort, and was back doing my normal routine with only slight modification within 2 months. I am very, very happy with Dr. Paley & his staff.”

Vitals.com

After another Doctor screwed my knee up and told me it was all in my head I went to Dr. Paley he has done two surgeries to correct the first one and is by far the best and most caring Doctor I have seen. His whole office staff are wonderful people that are always happy to be there and his Physicians Assistants actually know what they are doing. Great great great!

Healthgrades.com