Will My Carpal Tunnel Come Back After Carpal Tunnel Release?

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Will my carpal tunnel come back after carpal tunnel release? A quick online search of carpal tunnel and carpal tunnel release may leave you with more questions than answers.

Many of the top listings on major search engines, usually sponsored advertisements to online businesses trying to sell carpal tunnel splints, provide very misleading and false information for those suffering from carpal tunnel syndrome. Rather than encouraging patients to seek treatment from highly trained specialists, these websites use anxiety and fear to sell expensive splints that have very low success rates.

For example, one website called mycarpaltunnel.com quotes only 50 to 60% success rate for carpal tunnel release, with 85% of patients having their symptoms come back after surgery. Unfortunately, this website does not provide any source of information on where these numbers come from.

Most likely, they are pulling these numbers out of thin air and making them up so that you will buy their $185 splinting product.

These sites say things like “…most patients report permanent tenderness over the point of incision for years after surgery. Patients also report a permanent loss of grip strength for years.” Again, this is nothing more than gossip and does not reflect the reality of undergoing carpal tunnel release or healing after a carpal tunnel release procedure.

On the other hand, the real peer-reviewed scientific data on carpal tunnel syndrome and carpal tunnel release tells a different story.

The most quoted value for recurrence of carpal tunnel syndrome has been since the 90s between 5% to 20%. However as time goes and more high-quality studies are performed, many are questioning if there is truly such a problem as “recurrent carpal tunnel syndrome.” As in most fields of medicine and surgery, there are many factors that go into the success rate of a surgery. For example, how long was the carpal tunnel present prior to surgery? How damaged was the nerve from years living with carpal tunnel syndrome? What medical problems does the patient have? Does the patient have diabetes and thyroid disease? In properly conducted studies where these factors are accounted for, carpal tunnel syndrome does not seem to recur at all.

While recurrent carpal tunnel syndrome does exist and is a risk, if you have carpal tunnel symptoms, and you decide to have a carpal tunnel release, as a general rule you should not expect your symptoms to come back, ever.

References:

Kilinc F, Behmanesh B, Seifert V, Marquardt G. Does Recurrence of Carpal Tunnel Syndrome (CTS) after Complete Division of the Transverse Ligament Really Exist? J Clin Med. 2021 Sep 17;10(18):4208. doi: 10.3390/jcm10184208. PMID: 34575319; PMCID: PMC8470114.

Botte MJ, von Schroeder HP, Abrams RA, Gellman H. Recurrent carpal tunnel syndrome. Hand Clin. 1996 Nov;12(4):731-43. PMID: 8953292.

Dr. Nelson’s Research Published in December Issue of HAND

Carpal tunnel, Hand Surgeon, news

HAND Cover Along with Dr. Richard Singer and a team of researchers including Samuel Gay, Scott Diamond MD, and and Mitchell Gauger MD, Dr. Nelson recently published their findings from a retrospective study investigating the relationship between common hand conditions, such as carpal tunnel syndrome and trigger finger, and undiagnosed or “pre” diabetes.

Their study, titled “Warning Signs: Occult Diabetes and Dysglycemia in the Hand Surgery Patient Population,” was originally delivered as a podium presentation by Dr. Nelson at the 2020 Annual Meeting for the American Society for Surgery of the Hand. It suggests a strong link between carpal tunnel syndrome on both sides and early, undiagnosed, or impending diabetes or pre-diabetes. Male patients with elevated BMI and bilateral carpal tunnel syndrome were most at risk of having diabetes or pre-diabetes and not even knowing it!

It is well known that patients who have a diagnosis with diabetes are more likely to suffer from carpal tunnel syndrome and trigger finger, more likely to need surgery, and more likely to have continued nerve problems even if successful surgery is performed. What is NOT known, however, is how often patients have diabetes or pre-diabetes and don’t even know it, and the first “warning sign” is carpal tunnel symptoms.

“Hand surgeons encounter a patient population with high rates of undiagnosed prediabetes and diabetes, with some presentations as much as 6 times higher than the general population. Certain patient presentations should prompt appropriate diagnostic testing and referral, especially those presenting with bilateral compression neuropathy and elevated body mass index.” (Excerpt from Manuscript)

If you would like to read the manuscript, contact us here to request a free copy. Congratulations to Drs. Nelson, Singer, Gay, Diamond, and Gauger, and thank you for your contributions to our understanding of musculoskeletal conditions.

Can I Have My Carpal Tunnel Released on Both Sides at the Same Time?

Carpal tunnel, Hand Surgeon, Sonex, Ultrasound

What do I do if I have carpal tunnel on both sides?

Unfortunately, carpal tunnel syndrome is very common. 1 out of every 20 adult Americans has this condition, which can interfere with sleep, the quality of life, the use of the hands both at home and at work. Symptoms include numbness and tingling, especially in your thumb, pointer, and middle finger, waking up at night to shake your hands out, pain and numbness/tingling with activities that require gripping and repetitive wrist motions (holding a steering wheel, using tools, knitting, etc.).

Worse still, many have severe problems in both hands, and that may be YOU.

Sometimes simple treatments for carpal tunnel can help to quiet down your symptoms, especially if your symptoms came on recently. These include oral anti-inflammatories such as steroids or NSAIDs, wearing a wrist splint at night, avoiding activities that make your symptoms worse, and even injections performed by a hand surgeon such as Dr. Nelson.

But what happens when you have carpal tunnel on both sides that does not respond to these measures?

Carpal tunnel release is a great treatment for carpal tunnel syndrome. No matter how it is performed, it reliably relieves your numbness, tingling, and especially night pain and gripping pain due to carpal tunnel syndrome.

However, you may be worried about having surgery on both hands at the same time, also called “bilateral” carpal tunnel release. Maybe you have concerns that you will not be able to take care of yourself or others (children, elderly parents), dress yourself, use the bathroom, prepare food, and participate in other activities of daily life. Or perhaps you are concerned that you will have to take too much time off of work, and that is something you can’t afford. Simply put, you may feel the need to have one “good hand” to help out while the operated hand heals.

But with new technologies and techniques, this is no longer the case.

In years past, carpal tunnel release was always done through an open incision in the palm. While this can reliably treat and cure the symptoms of carpal tunnel syndrome, the incision in the palm can be painful especially in the early days and weeks after surgery. This can require prolonged periods of healing where heavier activities or even simple activities around the house can be difficult for you or need to be avoided altogether.

However, Dr. Johnny T. Nelson uses a new technology to treat your carpal tunnel syndrome under ultrasound guidance. Due to the extremely small sonexhealed incision (about the size of a pea!) further back on the wrist, and no incision on the palm, the same release and relief of your symptoms can be performed while minimizing the period of healing pain after the surgery.

With ultrasound guided carpal tunnel release, almost all patients with carpal tunnel on both sides have it treated on the same day. With ultrasound-guided carpal tunnel release, you may return to all activities immediately, including cooking, hygiene, dressing, and even work, including manual labor. There is no splinting or casting required, there is no heavy anesthesia on the day of surgery. Some patients who do very heavy work with their hands (for example, mechanics, plumbers, and other heavy laborers) may need to allow for 5-7 days for the area to heal.

In Dr. Nelson’s experience, he has yet to encounter a patient who has had ultrasound-guided carpal tunnel release done on both sides who wishes that they had it done only on one side. However, many patients who had it done on one side only for fear of the healing process wish they had it performed on both sides.

So to answer your question: YES! If you have carpal tunnel on both sides, and your symptoms are bad enough to need surgery, ultrasound-guided carpal tunnel release on the same day for both hands is often the best option for you. Click here for a complimentary printable handout about what to expect from ultrasound-guided carpal tunnel release.

Remember, every patient is different, your treatment depends on a one-on-one consultation with Dr. Johnny T. Nelson which includes a physical exam and discussion of your symptoms. If you are a candidate for ultrasound-guided carpal tunnel release, even if on both sides at the same time, he will let you know. Call 919-872-5296 for an appointment, or visit www.drnelsonctr.com to learn more.

Announcing: January 10th Carpal Tunnel Open House

Carpal tunnel, Hand Surgeon, Sonex, Ultrasound

Join Dr. Nelson for a free, no obligation scanning open house on January 10th from 6-8PM at the Bone & Joint Surgery Clinic!

While many struggle with hand and wrist problems, it is very difficult to get personalized, trustworthy advice. What is my diagnosis? What should I do? Who can I trust?

NOW IS YOUR CHANCE!

Dr. Nelson will give a short talk about the two most common conditions of the hand and wrist: carpal tunnel syndrome and trigger finger. This will be followed by individual “mini consultations.” You will have an informal chat with Dr Nelson and he will tell you your most likely diagnosis. If desired, Dr. Nelson will also have an ultrasound machine to scan your wrist and measure your carpal tunnel nerve to confirm the diagnosis for you.

Visit www.drnelsonctr.com for more information or to RSVP. You may also call his office directly and RSVP at 919-872-5296.

What are the advantages of ultrasound-guided carpal tunnel release?

Carpal tunnel, Hand Surgeon, Sonex, Ultrasound

What are the advantages of ultrasound-guided carpal tunnel release?

Dr. Johnny T. Nelson offers ultra–minimally invasive carpal tunnel release under ultrasound guidance. He is the first orthopedic surgeon in the Raleigh Durham area to perform this procedure, one of only two physicians in the state of North Carolina, and remains the only orthopedic surgeon offering this new technology for patients in the Raleigh-Durham area.

But what exactly is this procedure, and why is it better?

All carpal tunnel releases, no matter how they are performed, work by releasing pressure off of an important nerve at the level of the wrist, called the median nerve.

Carpal tunnel syndrome is very common, approximately 1 out of every 20 Americans suffers from this condition. That is A LOT of people. It causes numbness, tingling, pain, especially in the thumb, pointer finger, and middle finger, it is often worse at night. Patients often have to change what they are doing, or shake their hands out to make their symptoms better.

Unfortunately, many of these patients are reluctant to proceed with carpal tunnel release, even though this procedure would very likely cure their symptoms, help them to sleep a full night’s sleep, and continue to stay active and independent. There are many reasons why they remain reluctant, but the fear of surgery, either the pain or anxiety of the surgical procedure, or the fear of prolonged healing and pain after the procedure, are most likely the main reasons. Economic concerns are another reason.

Ultrasound guided carpal tunnel release helps to address these concerns.

This procedure can be done with local only anesthesia, meaning that Dr. Johnny Nelson can perform this without resorting to heavy medications, general anesthesia (for example, a sleeping tube down the patient’s throat), or expensive nerve blocks. This is not only usually less expensive for the patient, but also is a great option for patients with other medical issues that make anesthesia difficult.

Ultrasound-guided carpal tunnel release also is performed without a tourniquet. A tourniquet is a inflatable band that squeezes the arm being operated on so that the surgeon can see. Because Dr. Nelson uses ultrasound guidance, a tourniquet is unnecessary.

Finally, this procedure is done through a very tiny poke incision. Ultrasound-guided carpal tunnel release is the most precise way of releasing the pressure on your nerve without cutting and harming structures that are not involved with causing the carpal tunnel syndrome. This tiny poke incision, its very small size and location slightly on the forearm, especially placed to avoid incisions on the palm that are more likely to be sensitive and interfere with activities after surgery. As a result, many patients who have ultrasound-guided carpal tunnel release can return to their activities right away, certainly within 5 days of their procedure. No splint is necessary after surgery.

Do you have carpal tunnel syndrome? Does anyone you know or love have carpal tunnel syndrome? If so, call 919-872-5296 to schedule a visit with Dr. Johnny T. Nelson, MD for a consultation.

To learn more about ultra-minimally invasive carpal tunnel release, visit Sonexhealth.com.

Johnny Nelson is a fellowship-trained shoulder & hand doctor practicing in association with the Bone & Joint Surgery Clinic in Raleigh, North Carolina.

October 18th Carpal Tunnel Education Event – A Huge Sucess!

Carpal tunnel, Hand Surgeon, Sonex, Ultrasound

The October 16, 2022 scanning open house at the bone and joint surgery clinic with Dr. Johnny T. Nelson was a huge success!

The lobby of the bone and joint surgery clinic was filled with attendees, some of whom drove several hours for the event, to educate themselves about carpal tunnel syndrome and for the opportunity for a free one-on-one consultation with Dr. Nelson.

Many were also very curious to learn about ultrasound-guided carpal tunnel release, new technology being offered by Dr. Nelson. This ultra–minimally invasive technique of relieving carpal tunnel symptoms is changing the way that carpal tunnel syndrome is treated.

Dr. Nelson, one of the only orthopedic surgeons in the Raleigh Durham area to utilize in office ultrasound, also used ultrasound to confirm the diagnosis for many patients. This was a special teaching and learning opportunity, Dr. Nelson was able to teach each attendee about the anatomy of the carpal tunnel, the surrounding tendons and blood vessels, and signs on ultrasound that the carpal tunnel nerve may be abnormal.

If you or someone you know or love has carpal tunnel syndrome, and you are not able to attend the scanning open house, call 919-872-5296 to schedule visit with Dr. Johnny T. Nelson.

Free Scanning Open House at Bone & Joint Surgery Clinic – September 13th

Carpal tunnel, Hand Surgeon, Sonex, Ultrasound

Free Scanning Open House at Bone & Joint Surgery Clinic – September 13th

Do you wake up every night, shaking your hands out to make them stop hurting? Are you dropping things? Does pain or shooting electricity interruptsome of your favorite activities?

More importantly: are you ignoring or suffering through these symptoms because you are worried about what the doctor will say you need to make it better?

Dr. Johnny Nelson is hosting a free educational open house and scanning event at The Bone & Joint Surgery Clinic on Tuesday, September 13th at 6PM. Dr. Nelson will briefly help to explain carpal tunnel syndrome in simple, easy-to-understand terms and will explain a new ultrasound-guided technique for treating carpal tunnel symptoms with the UltraGuideCTR device. Dr. Nelson will then be available for informal consultation and a free ultrasound exam of your wrist to measure your carpal tunnel nerve and confirm your diagnosis.

Dr. Nelson is the first and remains the only orthopaedic surgeon in the Raleigh-Durham area to offer ultrasound-guided micro-invasive carpal tunnel release.

Are you interested in attending? Does someone you know or love have carpal tunnel syndrome and are avoiding treatment? Call 919-872-5296 to RSVP or visit www.DrNelsonCTR.com for more information.

sonex flyer — Call 919-872-5296 to RSVP or visit www.DrNelsonCTR.com for more information.

What are the Different Types of Carpal Tunnel Release?

Carpal tunnel, Hand Surgeon, Sonex, Ultrasound

What are the Different Types of Carpal Tunnel Release?

Do you have carpal tunnel syndrome?

While it is important to be properly evaluated and diagnosed by a fellowship trained upper extremity specialist such as Dr. Nelson, symptoms of carpal tunnel syndrome include numbness and tingling in the thumb, index, and middle finger, “shaking out” of the hands either at night or during the day, pain, cramping or weakness of the hands, dropping objects, and frequently being awoken by the symptoms.

If you do have carpal tunnel syndrome, chances are if your symptoms are bad enough, you will benefit immensely from carpal tunnel release. When treated with carpal tunnel release in a timely manner, your sensation will improve, your strength will likely improve, your sleep will improve, and your overall quality of life will improve.

But there are different ways of performing carpal tunnel release.

Traditional Open Carpal Tunnel Release Incision

Traditionally, carpal tunnel release was performed in an open fashion. This means that an incision is made over the base of your palm that is 1 to 2 inches in length, and through this incision, your surgeon will release the tight tissues that are pressing on the nerve in your wrist. While this is a time tested approach, this method is more painful and requires increased healing time after surgery. The incision usually requires sutures, there will be redness and bruising, and more soreness around the area of the surgery. If you do heavier things either at home or at work with your hands, it may take more time, even up to 6 weeks, to get back to work and activities that require gripping and lifting.

From the standpoint of early healing, endoscopic carpal tunnel release has fixed some of

endoscopic carpal tunnel surgery pt1b — Endoscopic Carpal Tunnel Release Incision

these early healing problems. Endoscopic carpal tunnel release is performed through a very small incision at the end of your wrist, not on the palm, and does not require an incision over the palm skin. While final outcome and patient satisfaction is the same compared to open release after 3 months, endoscopic release helps patients to get back to full activities, gripping, lifting and working much sooner with less pain, stiffness, scarring, and soreness after the surgery.

But wait, it gets better!

Recently, new techniques have become available to perform carpal tunnel release without anesthesia, under ultrasound guidance through a very tiny “poke” incision in the wrist. This procedure has been termed “micro-invasive CTR,” and soon will be offered by Dr. Nelson.

A large percentage of the American population has carpal tunnel syndrome, and many of those patients have moderate to severe carpal tunnel syndrome. Unfortunately, many patients avoid carpal tunnel release because they feel they do not have the time to heal after surgery or they are afraid of the soreness and pain that is part of the healing process.

Micro-invasive CTR under ultrasound guidance is a new answer for these patients. This procedure does not require anesthesia, it does not require a tourniquet, and eventually it will be offered in the office setting, even on the same day that you see Dr. Nelson to talk about your symptoms and confirm your diagnosis.

Do you or someone you know or love suffer from carpal tunnel symptoms? Make a visit to see Dr. Johnny Nelson today to discuss your diagnosis and her treatment options. Microinvasive CTR may be the right treatment for you!

Will My Carpal Tunnel Come Back After Carpal Tunnel Release?

Dr. Nelson’s Research Published in December Issue of HAND

Can I Have My Carpal Tunnel Released on Both Sides at the Same Time?

What do I do if I have carpal tunnel on both sides?

Worse still, many have severe problems in both hands, and that may be YOU.

But what happens when you have carpal tunnel on both sides that does not respond to these measures?

But with new technologies and techniques, this is no longer the case.

Announcing: January 10th Carpal Tunnel Open House

Join Dr. Nelson for a free, no obligation scanning open house on January 10th from 6-8PM at the Bone & Joint Surgery Clinic!

What are the advantages of ultrasound-guided carpal tunnel release?

What are the advantages of ultrasound-guided carpal tunnel release?

Ultrasound guided carpal tunnel release helps to address these concerns.

October 18th Carpal Tunnel Education Event – A Huge Sucess!

Free Scanning Open House at Bone & Joint Surgery Clinic – September 13th

Free Scanning Open House at Bone & Joint Surgery Clinic – September 13th

Dr. Nelson is the first and remains the only orthopaedic surgeon in the Raleigh-Durham area to offer ultrasound-guided micro-invasive carpal tunnel release.

What are the Different Types of Carpal Tunnel Release?

What are the Different Types of Carpal Tunnel Release?

But there are different ways of performing carpal tunnel release.

But wait, it gets better!

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