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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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  • 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
  • Thank you. - 06/11/15
  • It feels nice to be in a big Dr. office and still have that small town feeling. Thank you very much!! - 05/28/15
  • great job to all keep it up,wish more offices were like you all... - 12/01/14
  • 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
  • Awesome facility and staff! - 02/06/15
  • Thanks to the staff and Dr. Henry for being so helpful and attentive through the healing process. - 06/13/14
  • Very impressed with this entire operation and how smoothly everything ran. - 06/18/14
  • 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
  • Thank y'all so much. Looks like im healing well... - 05/21/15
  • Great Job! - 06/03/15
  • love the place and doc!!! - 07/10/14
  • Dr. Henry provided good clear explanations of my condition and answered all of my questions. - 08/01/14
  • I feel privileged to live where I can easily come to such a competent doctor. - 07/16/14
  • I continue to be exceptionally pleased with the doctor and staff at this clinic. Thank you for your professionalism and friendliness. - 05/29/15
  • love the friendliness and efficiency of the office - 02/11/15
  • outstanding experience. - 06/03/14
  • Great care! Would highly recommend - 09/19/14
  • The entire staff has been more than amazing through this process, I will for sure refer you all. - 06/12/15
  • awesome service and treatment. facility was very nice too - 06/24/14
  • I loved the service that I received at this facility. - 06/03/14
  • Very pleased with doctor & staff. - 10/14/14
  • DR Henry and staff have done a great job to get me back on track.Thank you. - 07/16/14
  • I cannot say enouhg good things about this place. Thank you all so much!!! - 06/06/14
  • I've been treated great by the staf. I think you'll are angels from heaven. - 12/18/14
  • I don't like the diagnosis but that's not Dr. Henry's fault. - 06/06/14
  • The staff is wonderful and Dr. Henry is amazing. - 03/31/15
  • 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
  • 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
  • THE DOCTOR EXPLAINED AND MADE SURE YOU HAD AN UNDERSTANDING OF WHAT WAS HAPPENING. - 10/02/14
  • very prfessional, put my needs and health above everything else! - 08/12/14
  • everyone VERY Professional! - 08/21/14
  • Always looking forward to visits, medical assistants and doctor care a lot about their patients! - 07/25/14
  • dr and staff r kick ass in helping me get my hand better thanks guys!!! - 07/10/14
  • Thank you! - 05/29/15
  • good - 02/25/15
  • I took some of your cards for my colleagues as well. very pleased. - 07/16/14
  • So glad to have my hand problem diagnosed and solved. Thank you so much. Great outcome. - 02/06/15
  • Absolutely would reccommend Dr. Henry and staff!Thank you! - 07/30/14
  • 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
  • Karen was Outstanding!! - 11/24/14
  • Both of my experiences here with Dr. Henry and his staff have been awesome. I appreciate him giving me my life back. Thank you Dr. Henry - 11/03/14
  • Great staff! - 07/23/14
  • 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
  • Dr Henry saved my broken hand. David and Lois were amazing. Thank you all so much for fixing my hand. - 06/06/14
  • This has been a life changing experience! Thank You Dr. Henry. - 08/27/14
  • Great job! - 07/11/14
  • Great staff, good attitudes. everyone was helpful - 09/29/14
  • they exolain everything and are very helpful thnks alot. - 11/14/14
  • Great Doc - 08/11/14
  • The staff was very professional and timely. I will recommend Hand and Wrist Clinic to family and friends. Thank you guys - 06/05/15
  • Spot on diagnosis. 90 days later back to doing everything as promised. - 08/20/14
  • Very thoughough in his examination of my issue and in the explanation of the possible causes. - 07/02/14
  • outstanding. - 07/09/14
  • Outstanding. Keep up the excellent work. - 05/19/15
  • A pleasant experience considering the reason for the visit. Couldnt be better - 11/12/14
  • Doc and staff were awesome!! Thanks a lot. - 02/03/15
  • great place was in and out. - 07/11/14
  • I feel taken care of - 05/27/15
  • I am pleased we came to Dr. Henry for my sons long finger fracture. - 06/05/15
  • Great Doctor. - 05/29/15
  • Teresa was very professional. - 07/15/14
  • Very good staff and and excellent Dr. I would recommend this office to friends and family. - 06/06/14
  • Felt informed and heard. - 06/06/14
  • David and Luis were also very professional and helpful - 07/11/14
  • I feel the doctor gave honest and very professional assessment. - 07/23/14
  • great service thanks soooooooo much - 09/30/14
  • Great Job - 06/09/14
  • great customer service!! - 04/29/15
  • Great facility and people - 05/28/15
  • 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
  • Outstanding experience!!! - 09/19/14
  • Very outstanding - 06/25/14
  • First visit. Very impressed and very comfortable with wound management decisions. - 06/08/15
  • very pleasant experience thanks for your help. - 12/16/14
  • I would recommend Dr. Henry and his staff. - 09/22/14
  • best doctors office - 03/06/15
  • 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
  • The care and treatment was exceptional. Staff was always friendly, and helpful. Could not have asked for a more satisfactory medical experience! - 10/31/14
  • Outstanding customer service! I would highly recommend this office to famly/friends. - 06/08/15
  • the servcie provided was great. some wait time improvements. overall a good experinece. Thank you - 07/11/14
  • 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
  • He was so thouough and knowledgeable and detailed!! Looking forward to getting this taken care of. Thanks. - 07/18/14
  • All medical staff prior to todays visit have been exceptional. Very friendly and helpful in all areas. - 07/10/14
  • Very good experience and immediate treatment. - 05/27/15
  • The doctor spoke to me with a genuine concern and I was able to understand options for treatment. - 06/03/14
  • Thank you for your professionalism - 05/20/15
  • Had a great experience here with both Doctor and staff. Very friendly and professional. - 04/30/15
  • Thanks - 02/20/15
  • 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
  • Thank you all for everything you do! Keep up the good work. - 07/21/14
  • felt confident on the treatment and the outcome of the results - 07/16/14










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