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CARPAL TUNNEL SYNDROME


WHAT YOU SHOULD KNOW

The carpal tunnel is a space near the wrist and palm where 9 tendons and the median nerve make a narrow passage under a tight band of tissue, the transverse carpal ligament. Carpal tunnel syndrome is when the tendons swell so much in the tight space that they put pressure on the nerve. Everyday use of the hands and certain positions of the wrist during daytime and nighttime, in certain instances, may be the only cause.

MEDICAL HISTORY

Patients usually complain of pain, numbness, and tingling that begins in the wrist region and travels out to the fingertips of the thumb, index, long, and ring fingers. The symptoms are often worse in the middle of the night causing waking or in the morning. Driving, fixing one's hair and time at the computer are other problem activities. When severe patients may even lose coordination and drop things.

carpal_tunnel_syndromeEXAMINATION

Pressure applied over the nerve at the wrist will recreate the pain, numbness, and tingling. The doctor will measure strength in the muscles (motor) and feeling ability (sensory) in the skin for specific areas serviced by the median nerve. In more advanced conditions, patients will demonstrate loss of motor and sensory functions.

ADDITIONAL TESTS

Electrical nerve tests provide actual numbers that tell the story of how well or poorly the nerve is conducting signals in the area of the carpal tunnel and if the muscles have sustained any damage as a result of prolonged nerve pressure.

TREATMENT OPTIONS

Despite what you may hear, Endoscopic Carpal Tunnel Release (ECTR) is not a new procedure, nor was it developed here in Houston. It was originally developed in 1987 by Dr. James Chow, MD, a highly respected hand surgeon in Illinois. Although some surgeons try to make this procedure seem unique by giving it a special name, it is still just a carpal tunnel release using a fiber-optic camera called an endoscope.

The correct (and fully inclusive) procedure code (CPT) used to bill an endoscopic tunnel release is 29848. As of 4/5/2013 our usual and customary fee for this procedure is $1,053.78. Please call for an up to date price. This fee does change frequently and most insurance companies and government payors such as Medicare either negotiate or legislate a discount for themselves.

Patients should be aware of several small but important differences among the various ways to view the inside of the carpal tunnel with an endoscope while cutting or “releasing” the carpal ligament with a blade. Perhaps the most important difference has to do with safety. In procedures where the surgeon operates the camera and the blade separately through two incisions, it is an unfortunate complication when the median nerve is accidentally cut.

The ECTR equipment Dr. Henry uses was developed by Dr. John Agee, MD, a hand surgeon in California. The design affixes the camera on the retractable blade at all times, which allows the surgeon to see exactly where, and what, the blade will cut. The endoscope and blade assembly all work together as a unit inserted through a single 1cm incision, with the blade retracted in the default position, and thus unable to inadvertently cut anything (like a nerve or tendon) until the surgeon chooses to deploy the blade. We believe this is the safest method for ECTR.

  NON-OPERATIVE ENDOSCOPIC CARPAL TUNNEL RELEASE
CONSISTS OF Night splints, ergonomic training, and cortisone shots into the carpal tunnel Release of the tight band, taking pressure off the nerve
FEATURES Limit of 2 cortisone shots designed to shrink tendon swelling Brief outpatient surgery using a fiber optic camera via a single 1cm incision at the wrist.
ADVANTAGES Avoids surgery Definitive solution to problem
DISADVANTAGES Only effective in mild cases Always the risk of scar tissue forming near nerve

RECOVERY

After the surgery no splints are used and there are no sutures that will need to be removed. Immediate use of the hand is encouraged for all light activities of daily living. Even forceful or heavy use of the hand is possible immediately, but such early over activity will be painful and is not encouraged. Specific therapy exercises should be done to limit scarring around the nerve. Return to a normal lifestyle is quite rapid.
 
 
 
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  • love the friendliness and efficiency of the office - 02/11/15
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  • I continue to be exceptionally pleased with the doctor and staff at this clinic. Thank you for your professionalism and friendliness. - 05/29/15
  • GREAT AND FAST TREATMENT FOR A PAINFULL EXPERIENCE - 02/01/16
  • As depressing as this process was for me the staff and doctor were great. Thanks for your services! - 08/26/15
  • I truly appreciate Dr. Henry's thorough explanation of everything pertaining to my carpal tunnel in both hands. He is very attentive and is genuinely concerned about his patients. Thanks to him and his great staff. - 02/03/16
  • Doc and staff were awesome!! Thanks a lot. - 02/03/15
  • Luis was great at check out as well. Nice to see a friendly face. - 02/04/16
  • best doctors office - 03/06/15
  • I am pleased we came to Dr. Henry for my sons long finger fracture. - 06/05/15
  • Thank you! - 05/29/15
  • The entire staff has been more than amazing through this process, I will for sure refer you all. - 06/12/15
  • Thank you for your professionalism - 05/20/15
  • Thank you for your care and treatment today. - 09/11/15
  • THE PROCEDURE WENT VERY VERY WELL AND MY HAND LOOKS AS THOUGH THE ACCIDENT NEVER HAPPENED. I AM VERY HAPPY AND WILL RECOMEND TO ANYONE DR. HENERY - 10/06/15
  • The staff was very professional and timely. I will recommend Hand and Wrist Clinic to family and friends. Thank you guys - 06/05/15
  • Have always had a good experience here. I have never had to wait more than 5 min in the waiting room nor more than 5 min in the exam room. Received surgery the same day as I was diagnosed. Best experience with a doctor's office ever! - 08/06/15
  • Thank You so much for all your help! - 02/10/16
  • Had a great experience here with both Doctor and staff. Very friendly and professional. - 04/30/15
  • Thank you. - 06/11/15
  • great customer service and health services - 09/23/15
  • He was excellent! - 10/30/15
  • Absolutely pleased with the results of my carpel tunnel surgeries on both hands. From start to finish my experience was very positive. Dr. Henry is an outstanding hand surgeon. - 12/03/15
  • very impressed with the time and care given to me by the doctor and Karen. They each made me feel like I was of their utmost importance! - 06/08/15
  • Very good experience and immediate treatment. - 05/27/15
  • I feel taken care of - 05/27/15
  • Fantastic Doctor and Staff. I would highly recommend (and often do) refer others to this clinic. Thanks for everything!!! - 07/17/15
  • I knew my son was in good care my sister worked with Dr. Henry before in surgery and recommended this practice stating you all are excellent! - 05/28/15
  • ALSO OUTSTANDING WORK BY OTHER MEDICAL ASSISTANT LUIS, DAVID, GREAT WORK AND KEPT ME VERY CALM. THANKS TO THE WHOLE TEAM. - 09/30/15
  • Great Doctor. - 05/29/15
  • The staff is wonderful and Dr. Henry is amazing. - 03/31/15
  • Outstanding. Keep up the excellent work. - 05/19/15
  • great customer service!! - 04/29/15
  • So glad to have my hand problem diagnosed and solved. Thank you so much. Great outcome. - 02/06/15
  • Thank you for your care and treatment today. - 09/11/15
  • Outstanding customer service! I would highly recommend this office to famly/friends. - 06/08/15
  • Great job all around. - 11/19/15
  • Miracle Healer! - 09/23/15
  • COULD NOT BE HAPPIER WITH THE SERVICE PROVIDED. DR HENRY REALLY KNOWS HIS STUFF AND THE STAFF IS INCREDIBLY HELPFUL AND KIND. I WILL DEFINITELY BE RECCOMENDING DR HENRY TO ANYONE I KNOW THAT NEEDS HAND OR WRIST HELP - 02/02/16
  • Great facility and people - 05/28/15
  • AWESOME - 10/22/15
  • Awesome facility and staff! - 02/06/15
  • The attention and the expertize is overwhelming. All I can say is, "I am playing the piano again" and I thank Dr. Henry and his staff for that. - 02/06/15
  • I am impressed and happy to see considerate individuals in the health profession. I would recommend this facility to anyone needing hand/wrist evaluation/medical assistance. - 02/06/15
  • Thank y'all so much. Looks like im healing well... - 05/21/15










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