| Carpal tunnel syndrome occurs when the median | | | | confirmation. |
| nerve, one of the major nerves that provides | | | | The initial treatment may consist of splinting as |
| innervation to the hand, is pinched in the carpal | | | | well as anti-inflammatory medications. Rest- |
| tunnel. The carpal tunnel is a narrow space on the | | | | staying away from keyboard work if this is what |
| palm side of the wrist. The "floor" of the tunnel is | | | | brought it on in the first place - is mandatory. |
| formed by the wrist bones; the roof is created | | | | If symptoms persist, then a corticosteroid |
| by a tough piece of tissue called the flexor | | | | injection into the carpal tunnel using ultrasound |
| retinaculum. If the carpal tunnel opening becomes | | | | needle guidance is a good option. Data indicates |
| constricted for whatever reason, then pressure is | | | | that this procedure may be very helpful in |
| exerted on the median nerve. The patient will | | | | alleviating the symptoms. In the past, patients |
| develop symptoms such as burning, numbness, | | | | who did not respond to injection and splinting |
| and tingling in the hand involving mostly the | | | | were probably considered candidates for surgery. |
| thumb, index, third, and part of the fourth fingers. | | | | A new technique may make this approach |
| If the pressure continues without adequate | | | | obsolete. |
| treatment, then the ability to use those fingers to | | | | Percutaneous needle release using ultrasound |
| grip will also worsen. | | | | guidance is a minimally invasive approach. Using |
| The carpal tunnel can be narrowed as a result of | | | | local anesthetic with ultrasound guidance, a small |
| trauma, edema (fluid build-up as occurs during | | | | needle is inserted and fluid is injected at the same |
| pregnancy), repetitive motion, thyroid disease, | | | | time to shred the fibers of the flexor retinaculum, |
| acromegaly (growth hormone excess), gout, and | | | | the tough band of tissue that forms the roof of |
| various forms of arthritis (rheumatoid arthritis is | | | | the carpal tunnel. With repeated passes of the |
| the most common). | | | | needle and further hydrodissection with fluid, the |
| The diagnosis is suspected by taking a careful | | | | retinaculum weakens and the physician is able to |
| history. Further corroboration is established | | | | gently break the retinaculum. A splint is applied |
| through a careful physical examination by a skilled | | | | and the patient is back to normal activities the |
| clinician. Nerve conduction tests are also helpful for | | | | next day. |