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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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  • great service thanks soooooooo much - 09/30/14
  • DR Henry and staff have done a great job to get me back on track.Thank you. - 07/16/14
  • Dr. Henry provided good clear explanations of my condition and answered all of my questions. - 08/01/14
  • really glad i chose to come here, every aspect of service was great - 04/01/14
  • Dr. Henry has been has done an excellent job getting my finger back in shape. The staff has been very helpful and attentive to my needs during this recovery. - 07/16/14
  • love the place and doc!!! - 07/10/14
  • Awesome as always :) - 02/24/14
  • This was a rare experience - service that was exceedingly competent, and exceedeingly considerate. A combination of the two = grateful patient. Thank you! - 08/15/14
  • All medical staff prior to todays visit have been exceptional. Very friendly and helpful in all areas. - 07/10/14
  • great place was in and out. - 07/11/14
  • Luis, Joel, Teresa and all the staff were very professional and helped me when needed. They are all an asset to your staff. - 08/14/14
  • Dr. Henry, as in the past, engendered my confidence and gave me peace of mind as a result of his exam and explanation. - 04/22/14
  • Discussed all of my options. Listened carefully to what I said and suggested different options that would help me to gain satisfaction. - 02/26/14
  • Love the Dr and the staff and I do refer everyone that has any complaint about their hands to come see Dr Henry because he is the best in Texas. I even had my mother come here after another "Dr." screwed up her hand. - 07/23/14
  • David and Luis were also very professional and helpful - 07/11/14
  • The doctor spoke to me with a genuine concern and I was able to understand options for treatment. - 06/03/14
  • I enjoy the decore and the attention and the young lady that sits in the front is very proffesional !!!! - 05/15/14
  • Great staff, good attitudes. everyone was helpful - 09/29/14
  • Wish I would have come to Dr. Henry years ago! Staff courteous and helpful. - 04/14/14
  • All of the medical assistants have been extremely outstanding during my care. - 05/20/14
  • thanks for getting her in so quickly - 05/21/14
  • very professional staff and services - 05/19/14
  • I feel the doctor gave honest and very professional assessment. - 07/23/14
  • THE DOCTOR EXPLAINED AND MADE SURE YOU HAD AN UNDERSTANDING OF WHAT WAS HAPPENING. - 10/02/14
  • could not be better - 02/19/14
  • outstanding. - 07/09/14
  • Thanks for saving my wrist! I'm Forever greatful. - 05/23/14
  • Thanks for spending the time to answer many complex questions. - 05/19/14
  • I've come here for two separate injuries & have been treated with kindness & respect both times. - 05/08/14
  • Overall this is a top 10% medical experience (perhaps top 1%) - 05/27/14
  • My first visit was wonderful, and every staff member that I encountered was extremely helpful. - 05/16/14
  • I don't like the diagnosis but that's not Dr. Henry's fault. - 06/06/14
  • thanks for all the kindness and help - 05/15/14
  • felt confident on the treatment and the outcome of the results - 07/16/14
  • very prfessional, put my needs and health above everything else! - 08/12/14
  • Awesome as always. - 05/27/14
  • Overall, my association with the office was a very good experience. - 04/29/14
  • dr and staff r kick ass in helping me get my hand better thanks guys!!! - 07/10/14
  • Dr. Henry explained the options in much more detail than the initial orthopedic hand specialist. His questioning, examination, and explantion of my condition was very thorough. - 05/30/14
  • Great Job. I have full confidence in Dr. Henry'a ability to diagnose and take care adequately of the problems on my left hand. - 06/26/14
  • the servcie provided was great. some wait time improvements. overall a good experinece. Thank you - 07/11/14
  • Dr. Henry is an incredible surgeon and would recommend to anyone. His staff (David in particular) was very helpful and made sure I got what I needed. - 05/23/14
  • Outstanding care throughout my surgery treatment and followup care - 04/14/14
  • I would recommend Dr. Henry and his staff. - 09/22/14
  • Great job! - 07/11/14
  • I feel privileged to live where I can easily come to such a competent doctor. - 07/16/14
  • everyone is very professional - 05/23/14
  • Teresa was very professional. - 07/15/14
  • Great difference from my first doctor. Everything was better. My pain has subsided and I am well aware of the possibility of my recovery being okay. - 07/16/14
  • He was so thouough and knowledgeable and detailed!! Looking forward to getting this taken care of. Thanks. - 07/18/14
  • efficient not hurried helpful - 05/19/14
  • This is the best of the BEST! - 01/08/14
  • As long as he is here i will come to him and even if he move i will follow him and everyone in the office was nice - 05/19/14
  • Absolutely would reccommend Dr. Henry and staff!Thank you! - 07/30/14
  • Great care! Would highly recommend - 09/19/14
  • Outstanding experience!!! - 09/19/14
  • I loved the service that I received at this facility. - 06/03/14
  • Thanks to the staff and Dr. Henry for being so helpful and attentive through the healing process. - 06/13/14
  • outstanding experience. - 06/03/14
  • good job! - 05/28/14
  • I took some of your cards for my colleagues as well. very pleased. - 07/16/14
  • WE were highly satisfied with the service we received and the friendliness of the entire staff! Thank you!! - 05/09/14
  • Very pleased with doctor & staff. - 10/14/14
  • the office was grate! - 05/08/14
  • Thank you all for everything you do! Keep up the good work. - 07/21/14
  • Very impressed with this entire operation and how smoothly everything ran. - 06/18/14
  • Felt informed and heard. - 06/06/14
  • Spot on diagnosis. 90 days later back to doing everything as promised. - 08/20/14
  • I AM SO GLAD I CHOSE THIS DR HE IS GREAT AND SO IS ALL STAFF MEMBERS - 04/18/14
  • Very outstanding - 06/25/14
  • I look forward to healing. Thank You Doctor and Staff. - 02/20/14
  • Most professional and helpful for a first fracture in my life at 60 years old. Loved all staff and therapy. Thanks - 02/25/14
  • awesome service and treatment. facility was very nice too - 06/24/14
  • This has been a life changing experience! Thank You Dr. Henry. - 08/27/14
  • Dr Henry saved my broken hand. David and Lois were amazing. Thank you all so much for fixing my hand. - 06/06/14
  • Always looking forward to visits, medical assistants and doctor care a lot about their patients! - 07/25/14
  • Great Job - 06/09/14
  • The Dr took my appointment last minute. I'm very appreciative of that. - 03/04/14
  • The facifility was able to get me in right away for what seemed liked a minor issue that ultimately required surgery that was done the same day (no waiting). - 09/22/14
  • Outstanding healthcare staff !!! - 05/19/14
  • I cannot say enouhg good things about this place. Thank you all so much!!! - 06/06/14
  • Great staff! - 07/23/14
  • I enjoy the decore and the attention and the young lady that sits in the front is very proffesional !!!! - 05/15/14
  • everyone VERY Professional! - 08/21/14
  • Great Doc - 08/11/14
  • If there was a category over outstanding I would have checked that one! - 03/07/14
  • very outstanding visit and the personal all where outstanding. Doctor is very outstanding. thank you for getting me in at the short notice. thank you again - 02/27/14
  • Very thoughough in his examination of my issue and in the explanation of the possible causes. - 07/02/14
  • Very good staff and and excellent Dr. I would recommend this office to friends and family. - 06/06/14
  • This was the most professional, responsive and ethical evaluation I have received during my 63 years of receiving physician evaluations. - 05/28/14










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