Will My Carpal Tunnel Syndrome Come Back After I Have A Carpal Tunnel Release?

Carpal tunnel, Hand Surgeon, Sonex, Ultrasound

Will My Carpal Tunnel Syndrome Come Back After I Have A Carpal Tunnel Release?

This is a question that North Carolina carpal tunnel expert Dr. Johnny T. Nelson, MD hears a lot.

Understandably, patients want to know if a treatment for carpal tunnel syndrome will be permanent or only temporary. Carpal tunnel syndrome can cause severe problems with work, sleep, and home life, so patients do not want it to return.

For 99% of patients, the answer is NO, your carpal tunnel syndrome will not come back!

This is very good news. Carpal tunnel release, especially carpal tunnel release with ultrasound guidance, has a very high rate of permanent cure and patient satisfaction. This satisfaction lasts a long time, usually lifelong, according to studies.

However, it is important to understand that there are rare situations where carpal tunnel syndrome or similar nerve problems can return. For example, those with diabetes, thyroid problems, or a history of extensive surgery or scarring may be at risk of repeat nerve problems in the future.

If you schedule a visit with Dr. Johnny T. Nelson, MD, he will likely ask you about medical problems that may place you at risk for nerve problems in the future. He will also perform an exam of your hand and wrist to see if you have other problems that may cause the carpal tunnel syndrome to come back.

Dr. Nelson will also tell you if your carpal tunnel syndrome and nerve problems are very bad. If the nerve problems are very bad, sometimes the problems can be permanent, even if treated by a highly trained specialist.

If you have carpal tunnel syndrome and are growing tired of the numbness, tingling, and waking up at night, call 919-872-5296 today to schedule a visit with Dr. Johnny T. Nelson, MD.

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When Can I Return to Work after My Carpal Tunnel Release?

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When Can I Return to Work after My Carpal Tunnel Release?

When Raleigh, North Carolina Carpal Tunnel Specialist Dr. Johnny T. Nelson, MD hears this question, he responds with a question: What do you do for work?

If you have carpal tunnel syndrome or are considering a carpal tunnel release, chances are you are planning to have a minimally invasive ultrasound-guided carpal tunnel release. Although there are other options, carpal tunnel release with ultrasound guidance allows for quick relief of carpal tunnel symptoms without the need for IVs, anesthesia, sutures, splinting, therapy, and…you guessed it: work restrictions!

But when it comes to returning to work after a carpal tunnel release, there are a few other things to consider.

Since 2022, North Carolina carpal tunnel specialist Dr. Johnny T. Nelson, MD has performed over 700 carpal tunnel releases with ultrasound guidance. Many of these patients were very busy hairdressers, plumbers, welders, electricians, and delivery drivers. And many of these patients went back to work at 1 to 3 days after the procedure!

While many of these patients had mild soreness in the palm, they were able to return to work because even their heavy work activities cannot do “damage” to the work that was done. Some of these patients did use oral medications like Tylenol or anti-inflammatories at first to allow them to work in comfort. After a few weeks, most of these patients reported being back to normal and no longer needing any medication.

Patients who work “desk jobs,” such as clerks, secretaries, receptionists, salespeople, and other similar professionals can easily return to work after 24 hours.

Studies do show that after a carpal tunnel release, pinch and grip strength does decrease for a short time. During this time, if you work a heavy job, your performance may not be normal. As your hand continues to heal, pinch and grip strength returns to normal. Soon, your job performance will also return to normal.

Dr. Nelson also recommends that in the first 24 hours after carpal tunnel release with ultrasound guidance, the hand or hands are kept elevated and ice is used. During this time, it is not recommended to work. But after 24 hours, activities can be restarted “as tolerated,” meaning that as long as you are comfortable performing the activity, you can do it.

If you have carpal tunnel syndrome and are worried about the time it takes to return to work after a carpal tunnel release, call 919-872-5296 today to schedule a visit with Dr. Johnny T. Nelson, MD.

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Why Are Carpal Tunnel Symptoms Worse At Night?

Carpal tunnel, Hand Surgeon, Ultrasound

Why Are Carpal Tunnel Symptoms Worse At Night?

If you have carpal tunnel syndrome, it is very likely that you are feeling discomfort. This discomfort is different in different patients. Raleigh, North Carolina, carpal tunnel expert Dr. Johnny T. Nelson, MD understands that carpal tunnel syndrome and similar nerve problems come in different “flavors.”

The most common symptom that patients feel is pain, numbness, tingling in the hands at night. Carpal tunnel syndrome and similar nerve problems are special in this way. They almost always bother you more at night.

But why does carpal tunnel syndrome and carpal tunnel symptoms seem to be worse at night?

The answer is complex, but there are several explanations.

First of all, during the day our brains are very active. Multiple signals are coming and going from the brain to the limbs, and from the limbs to the brain. There are external noises, people moving around this, work we need to do, and other feelings coming from all sides. However, at night, a lot of this “noise” quiets down. As a result, nerve problem such as carpal tunnel syndrome are no longer “drowned out” by the noise. As a result, the carpal tunnel “noise” seems louder and more painful. This is why patients with carpal tunnel syndrome report waking up at night, hanging their hands off the edge of the bed, and flicking or shaking their hands and fingers.

The second explanation has to do with being still while we sleep. During the day, we are using our hands, moving our arms to do things like to eat, drink, work, drive a car, and play with her children. This motion helps to keep fluid and blood from building up in her hands and feet. The movement of the muscles and joints actually helps to “pump” swelling back to the heart. But at night, when we are still, fluid and swelling tends to build up in our hands and feet. As a result, this small amount of swelling can “crowd out” the carpal tunnel nerve and make carpal tunnel symptoms worse.

Finally, when we sleep we tend to “curl up like a baby.” We like to clinch our fists, bend our wrists and elbows close to our body. These positions, although they are comfortable, actually increase pressure on the carpal tunnel nerve. In fact, when Dr. Johnny T. Nelson, MD is testing you for carpal tunnel syndrome, one of the movements he tests is to bend the wrist and hold it in this position. If this creates carpal tunnel symptoms or makes them worse, you have carpal tunnel syndrome.

If you have carpal tunnel syndrome and are having a hard time sleeping, call 919-872-5296 today to schedule a visit with North Carolina Carpal Tunnel Expert Dr. Johnny T. Nelson, MD.

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Carpal Tunnel Release Through A Tiny Skin Poke: How Is That Possible?

Carpal tunnel, Hand Surgeon, Ultrasound

Carpal Tunnel Release Through A Tiny Skin Poke: How Is That Possible?

If you have carpal tunnel syndrome or are thinking about a carpal tunnel release procedure, you may have questions about your incision!

Carpal tunnel release is a time-tested surgery that cures carpal tunnel syndrome for good. It has very high success rates. There are also many different ways to perform a carpal tunnel release. If you are scheduled to have a carpal tunnel release surgery, you should ask your surgeon what type of release will be performed and what your incision will look like.

Raleigh, North Carolina, Carpal Tunnel Specialist Dr. Johnny T. Nelson, MD specializes in advanced ultrasound-guided surgery. As a result, this special skill allows Dr. Nelson to perform a carpal tunnel release through a 5 mm “poke” in the skin of the wrist.

How is this possible?

All carpal tunnel release procedures do the same thing. The goal of a carpal tunnel release is to open a special band inside the wrist that allows the carpal tunnel to grow slightly wider. When the tunnel grows slightly wider, the carpal tunnel nerve has more room to “breathe.” So whether your surgeon performs an open carpal tunnel release or an ultrasound-guided carpal tunnel release, the goal is the same.

But what is different is how they get there!

Open carpal tunnel release arrives at the special ligament by going through the skin of the palm. To do this, an incision is necessary in the thick skin of the palm, which has more nerve endings. Other structures have to be cut through as well, including a special tissue called “fascia” deep to the skin. Dr. Johnny T. Nelson, MD describes the skin and the fascia as “innocent bystanders.” They do not cause carpal tunnel symptoms but need to be cut through for a open carpal tunnel release.

On the other hand, carpal tunnel release with ultrasound guidance allows the most targeted treatment possible. Through a tiny 5 mm poke incision, Dr. Nelson is able to release the special ligament only. There is no incision on the palm skin, and there is no “innocent bystander” tissue! Think of this as performing carpal tunnel release from the “inside out.” This is not possible without a special camera or an ultrasound machine.

So how is it possible? It is possible because of ultrasound!

If you have carpal tunnel syndrome, numbness, tingling at night or during the day, call 919-872-5296 today to schedule your visit with Dr. Johnny T. Nelson, MD.

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How Does a Carpal Tunnel Release Work?

Carpal tunnel, Hand Surgeon, Ultrasound, Uncategorized

How Does a Carpal Tunnel Release Work?

To understand how carpal tunnel release works, it is important to understand the problem of carpal tunnel syndrome.

Carpal tunnel syndrome is caused by pressure on a very important nerve at the level of the wrist. This nerve is called the median nerve.

At the level of the wrist, the median nerve passes through a “tunnel,” along with several important tendons that move the fingers and the thumb. This tunnel cannot change in size, it cannot grow wider or more narrow as needed. Because of this, if there is swelling of the tendons and other structures in the tunnel, the nerve gets “crowded out.” The nerve is pinched and constricted in the carpal tunnel.

The pinching of this nerve is bad because a nerve is like an electrical cable: It works by sending signals back-and-forth between the hand and the brain. The signals are mostly “feeling” signals but also can be signals to the muscles in the thumb. If the electrical cable is crushed and loses its ability to send signals, the human brain notices this and experiences numbness, tingling, discomfort, pain which are together called carpal tunnel syndrome.

So how does a carpal tunnel release work?

A carpal tunnel release is a very simple idea. The “roof” of the tunnel is made of a ligament. A carpal tunnel release divides this ligament which allows the tunnel to slightly widen. This allows the nerve to have more “breathing room” so that it can work normally again. As a result, a patient who has a carpal tunnel release can sleep at night, hold a steering wheel without shaking their hands out, etc.

Ultrasound-guided carpal tunnel release, as performed by Dr. Johnny T. Nelson, MD, North Carolina carpal tunnel specialist, widens the carpal tunnel in a very special way. It requires only a tiny “poke” incision about the size of a pea, and the ligament is released from the “inside out.”Therefore, there is no incision in the palm, no need for sutures, no need for splinting, no need for an IV or expensive anesthesia.

Do you have carpal tunnel symptoms? Have you tried splinting, injections, anti-inflammatories and you still have symptoms? Call 919-872-5296 today to schedule a visit with Dr. Johnny T. Nelson, MD, North Carolina’s carpal tunnel specialist!

How Does a Carpal Tunnel Release Work? Read More »

What If I Choose To Live With My Carpal Tunnel Syndrome And Not Have It Treated?

Carpal tunnel, Hand Surgeon, Ultrasound, Uncategorized

What If I Choose To Live With My Carpal Tunnel Syndrome And Not Have It Treated?

This is a question that Raleigh, North Carolina carpal tunnel specialist Johnny T. Nelson, MD thinks about a lot. He also spends a lot of time talking to patients about this question.

First, it is important to understand that carpal tunnel syndrome is not an emergency condition. It is not like a problem with your heart or lungs that can cause complete disability or even death. So living with carpal tunnel syndrome is an option. Before modern technology like carpal tunnel release using ultrasound guidance, every human being with carpal tunnel syndrome had to live there entire life with carpal tunnel syndrome.

Second, we do not have very much scientific information about what happens to patients who choose to live with their carpal tunnel syndrome. This is simply because no doctor or scientist has studied this in detail. Some scientific studies show that some patients improve over time while carpal tunnel symptoms worsen or become permanent and others.

But what we do know is that if you choose to live with carpal tunnel syndrome, you are taking a risk.

When the carpal tunnel nerve is pinched for a long time, it does not work properly. With a carpal tunnel release procedure, this pinching is relieved and the nerve is allowed to work properly again. If the nerve is pinched for a long time, the symptoms such as loss of feeling in the fingers, pain, and weakness can become permanent.

There is only so much pressure a nerve can take!

Some patients who choose to live with carpal tunnel learn to “live with it.” Raleigh, North Carolina carpal tunnel specialist Dr. Johnny T. Nelson, MD does not recommend this. While the carpal tunnel syndrome may feel like it is improving, what is actually happening is the human brain is learning to “tune out” the pain signals coming from the nerve. The patient may not experience much discomfort and pain, and may even feel like they are sleeping better again, but the feeling in their fingertips does not come back, and their thumb muscles grow very weak. As a result, these individuals are clumsy and frequently drop objects and have weak hands.

If you have carpal tunnel syndrome but do not have the time or resources to have it treated with a carpal tunnel release procedure, you should schedule a visit with Dr. Johnny T. Nelson, MD. There are other ways to treat your symptoms and help you to live a good life temporarily until you have the ability to treat your symptoms for good. Call 919-872-5296 today to schedule your visit!

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Do I Need to Wear a Splint after I Have My Carpal Tunnel Release?

Carpal tunnel, Hand Surgeon, Ultrasound, Uncategorized

Do I Need to Wear a Splint after I Have My Carpal Tunnel Release?

You may have family or friends that had a carpal tunnel release procedure. Most likely they were placed into a splint for the early days of the healing process after the surgery.

This is actually quite common, since most carpal tunnel releases performed in the United States are done through an “open” incision in the palm. Because of the larger incision and the location of the incision, open carpal tunnel release is more painful, requires suture, and requires longer healing time. To avoid problems with the incision, a splint is placed for 10 days or 2 weeks after the procedure.

But ultrasound technology has changed all of this!

Raleigh, North Carolina carpal tunnel specialist Dr. Johnny T. Nelson, MD treats carpal tunnel syndrome with ultra minimally invasive release under ultrasound guidance. This requires only a very small (5 mm, about the size of a pea) poke incision on the wrist, not the palm. This poke incision does not require suture and heals much quicker than an incision in the palm. Because of this, Dr. Nelson does not need to place carpal tunnel patients into a splint after their procedure.

That is right, after ultrasound-guided carpal tunnel release, no splint is necessary!

While Dr. Nelson will place a small, light soft dressing on the hand and wrist, this is removed 1 or 2 days after the procedure. Because it is soft and light, you are able to perform important activities right away: Eating, drinking, dressing, bathroom, hygiene, etc. After the dressing is removed, you may wash your hands and take a shower and get clean water on the site of the surgery.

If you are concerned about how long it will take you to heal after carpal tunnel release surgery, call 919-872-5296 today to schedule a visit with Dr. Johnny T. Nelson, MD, North Carolina carpal tunnel expert!

Do I Need to Wear a Splint after I Have My Carpal Tunnel Release? Read More »

I Think I Have Carpal Tunnel Syndrome. Do I Need Nerve Studies?

Carpal tunnel, Hand Surgeon, Ultrasound, Uncategorized

I Think I Have Carpal Tunnel Syndrome. Do I Need Nerve Studies?

If you have been told that you need to have nerve studies, also called “electrodiagnostic studies,” it is possible that you have been diagnosed with a nerve condition like carpal tunnel syndrome.

Nerve studies work by using electric signals and shocks to study how well nerves are working. They can be helpful in certain situations to tell if a nerve is not working correctly. While they can be useful, they can also be painful, expensive, and time-consuming.

And they also may be completely unnecessary!

Carpal tunnel specialists like Dr. Johnny T. Nelson, MD understand that nerve studies are not always necessary. For most patients, a few simple questions and a few simple examination signs will tell Dr. Nelson whether or not you have carpal tunnel. A very quick and painless 30 second ultrasound scan will further confirm the diagnosis.

Did you know that 1 out of every 5 patients with carpal tunnel syndrome have normal nerve studies?

It is a good idea to start with a carpal tunnel specialist, such as Dr. Johnny T. Nelson, MD, before you have your nerve studies completed. If nerve studies are truly necessary, he will order the nerve studies and review the results with you. If they are not necessary, Dr. Nelson diagnosed you properly and very likely perform a quick and painless ultrasound scan to confirm your diagnosis.

If you have carpal tunnel or are considering having a release procedure, make sure you call 919–872–5296 today to schedule a visit with Dr. Johnny T. Nelson, MD, North Carolina carpal tunnel expert!

I Think I Have Carpal Tunnel Syndrome. Do I Need Nerve Studies? Read More »

Is It Normal to Have Redness around My Incision after Ultrasound-Guided Carpal Tunnel Release?

Carpal tunnel, Hand Surgeon, Sonex, Ultrasound

The short answer is: Yes!

Before we explain, it is important to understand that if you have questions about your surgery, your incision, or any concerns about redness, swelling, pain, etc., it is very important to consult the surgeon who performed your procedure. While redness can be a normal response of the human body to a procedure, including carpal tunnel release for carpal tunnel syndrome, it could also represent the signs or symptoms of an infection.

sonexhealed When a surgeon, such as Dr. Johnny T. Nelson, MD, performs a carpal tunnel release procedure, it is necessary to make a small opening in the skin. This opening, called and “incision,” allows the hand specialist to introduce a special device into the carpal tunnel. This allows the carpal tunnel to be released from the “inside out.”

It is important to understand that when a cut or injury happens by accident, the human body responds right away. This response ensures that bacteria and bugs from the outside world do not find their way inside the body and cause an infection. The signs of this response include warmth, redness, and swelling.

But the human body cannot tell the difference between an accidental cut and a surgical incision.

Because the human body sees the surgical incision the same as an accidental cut, it is normal to see some of the same signs. These include warmth, redness, and swelling. This is often called the “inflammatory” steps of healing. Your hand specialist, Dr. Johnny T. Nelson, MD, will counsel you on what to expect after your ultrasound-guided carpal tunnel release procedure.

And most importantly, if you undergo a carpal tunnel release procedure, Dr. Nelson will follow you closely to make sure that you are healing well.

Is It Normal to Have Redness around My Incision after Ultrasound-Guided Carpal Tunnel Release? Read More »

The Benefits of Wide Awake Procedures

Carpal tunnel, Hand Surgeon, Sonex, Ultrasound

Wide Awake Carpal Tunnel Release What is it like to be awake during a procedure?

You may have carpal tunnel syndrome or trigger finger. If so, you may be considering surgical treatment to cure the symptoms forever. Dr. Johnny Nelson is an expert in carpal tunnel release and trigger finger release with real-time ultrasound guidance. He also performs many other procedures around the hand and wrist.

It may sound crazy to some, but one option is to remain completely awake during your procedure.

If you are considering surgery, your surgeon should discuss different options for anesthesia. Wide-awake surgery is not possible or encouraged with some procedures. For example, major hip or knee surgery, spine surgery, or shoulder surgery requires at least sedation or “sleeping medicine.” Dr. Johnny T. Nelson is a Raleigh North Carolina shoulder specialist, and all patients who have shoulder surgery or rotator cuff repair have at least sedation during their procedure.

But wide-awake surgery is very common and for most small hand procedures is a very good option.

Dr. Nelson has performed over 700 carpal tunnel releases with real-time ultrasound guidance, and no patient has ever needed sedation or general anesthesia.

Being wide-awake during surgery does not mean that you will feel pain! Dr. Nelson uses numbing medicine, usually applied gently around the surgical site just before the procedure begins. The difference is that you will not need an IV, any sleeping medicine, and no tube will be placed down your throat to keep you asleep during the procedure.

The closest analogy is going to the dentist. Most patients go to the dentist and have dental work done without being asleep. If deeper work is necessary, there are situations where dentists give sleeping medicine. But usually the most that they need to do is inject some numbing medicine.

Thanks to new technology, carpal tunnel release can now be performed with real-time ultrasound guidance. This wide-awake procedure is more comfortable overall. There are no burning medicines given through an IV that leave you groggy and nauseated.

Also, with wide awake surgery there are little or no anesthesia risks. Many patients have medical conditions, such as heart or lung problems, that make traditional anesthesia higher risk or more difficult. As a result, no medical clearance is necessary from your medical doctor, and you do not need to stop blood thinners!

Finally, because of all these benefits, wide-awake surgery is perfect for the office setting. The anxiety caused by being in a hospital or operating room is a thing of the past!

If you have carpal tunnel syndrome, call 919-872-5296 or contact us to schedule your visit with Dr. Johnny T. Nelson MD, North Carolina’s premier carpal tunnel specialist.

The Benefits of Wide Awake Procedures Read More »

carpal tunnel

Will My Carpal Tunnel Syndrome Come Back After I Have A Carpal Tunnel Release?

For 99% of patients, the answer is NO, your carpal tunnel syndrome will not come back!

If you have carpal tunnel syndrome and are growing tired of the numbness, tingling, and waking up at night, call 919-872-5296 today to schedule a visit with Dr. Johnny T. Nelson, MD.

When Can I Return to Work after My Carpal Tunnel Release?

But when it comes to returning to work after a carpal tunnel release, there are a few other things to consider.

Patients who work “desk jobs,” such as clerks, secretaries, receptionists, salespeople, and other similar professionals can easily return to work after 24 hours.

Why Are Carpal Tunnel Symptoms Worse At Night?

But why does carpal tunnel syndrome and carpal tunnel symptoms seem to be worse at night?

Carpal Tunnel Release Through A Tiny Skin Poke: How Is That Possible?

If you have carpal tunnel syndrome or are thinking about a carpal tunnel release procedure, you may have questions about your incision!

How is this possible?

But what is different is how they get there!

So how is it possible? It is possible because of ultrasound!

How Does a Carpal Tunnel Release Work?

So how does a carpal tunnel release work?

What If I Choose To Live With My Carpal Tunnel Syndrome And Not Have It Treated?

But what we do know is that if you choose to live with carpal tunnel syndrome, you are taking a risk.

There is only so much pressure a nerve can take!

Do I Need to Wear a Splint after I Have My Carpal Tunnel Release?

But ultrasound technology has changed all of this!

That is right, after ultrasound-guided carpal tunnel release, no splint is necessary!

I Think I Have Carpal Tunnel Syndrome. Do I Need Nerve Studies?

And they also may be completely unnecessary!

Did you know that 1 out of every 5 patients with carpal tunnel syndrome have normal nerve studies?

The short answer is: Yes!

But the human body cannot tell the difference between an accidental cut and a surgical incision.

It may sound crazy to some, but one option is to remain completely awake during your procedure.

Dr. Nelson has performed over 700 carpal tunnel releases with real-time ultrasound guidance, and no patient has ever needed sedation or general anesthesia.

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