What Are the Risks of Carpal Tunnel Release?

Carpal tunnel, Hand Surgeon, Sonex, Ultrasound

What Are the Risks of Carpal Tunnel Release?

If you have carpal tunnel syndrome or any other medical problem, you may be thinking about a surgical procedure. With modern technology, surgical procedures to treat serious medical problems are improving every year. Scientific studies, new techniques and devices, better understanding of medical problems all help to improve the surgical care provided.

But you may still feel nervous about having surgery!

This is very normal. Most patients who have a surgical procedure report feeling nervous at some stage of the planning process. This is why it is very important to see a well-trained specialist about the problem that you are having.

If your problem is carpal tunnel syndrome, North Carolina Carpal Tunnel Specialist Dr. Johnny T. Nelson, MD is the well-trained specialist for you!

Dr. Nelson takes pride in spending time with every patient, making the best decision for them based on their plans, needs, and special situations. He also takes pride in listening closely to questions and concerns, especially when surgery is being considered. When a carpal tunnel release is considered, Dr. Nelson discusses the risk of surgery with every patient.

It is helpful to think about surgery likely think about driving a car. Every time we get into a car or leave our house, we are taking a risk. It is always possible that something bad can happen. The risk is very, very small, but the risk does exist!

Carpal tunnel release with ultrasound guidance helps to make sure that the risk is as small as possible!

Because there is no anesthesia, the risk of anesthesia is much lower. Anytime there is an incision, there is a risk for infection. But the smaller the incision, the smaller the risk for infection. The 5 mm poke incision used for ultrasound-guided carpal tunnel release is extremely small. When surgery is performed, there is always a risk of damage to other structures, such as tendons, nerves, or blood vessels. Because carpal tunnel release performed by Dr. Nelson is done under ultrasound guidance, he can see all of the structures all at once, and keep them all safe.

If you have carpal tunnel syndrome and are ready to get rid of your symptoms for good, call 919-872-5296 today to schedule a visit with Dr. Johnny T. Nelson, MD, Raleigh, North Carolina, shoulder and carpal tunnel specialist!

What Are the Risks of Carpal Tunnel Release? Read More »

Can I Have Carpal Tunnel Release On Both Sides At Once?

Carpal tunnel, Hand Surgeon, Sonex, Ultrasound

Can I Have Carpal Tunnel Release On Both Sides At Once?

Unfortunately, carpal tunnel syndrome is very common. One out of every 20 adult Americans has this condition, which can interfere with sleep, work, and free-time activities. Worse still, many have severe problems in both hands.

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

But what do I do when carpal tunnel on both sides does not get better?

Carpal tunnel release is the time-tested treatment for carpal tunnel syndrome. It reliably and quickly relieves the numbness, tingling, and especially night pain and gripping pain due to carpal tunnel syndrome. And in most patients, it does this permanently!

However, patients with carpal tunnel on both sides, also known as “bilateral carpal tunnel syndrome,” worry about having surgery on both hands at the same time. Some are concerned that they will not be able to take care of themselves. For example, they are worried that dressing, going to the bathroom, picking up a small child will become too difficult. Simply put, they feel they need to have one “good hand” to help out while the operated hand heals.

But with new technology and a technique offered by North Carolina Carpal Tunnel Specialist Dr. Johnny T. Nelson, MD, this is no longer the case.

For many years, carpal tunnel release was done with an open incision in the palm. While this treats and cures the symptoms of carpal tunnel syndrome, the incision in the palm can be painful, especially in the early days after surgery. This can require a prolonged healing time, where heavy or even simple, light activities around the house can be difficult.

However, Dr. Johnny T. Nelson is an expert in the treatment of carpal tunnel syndrome under ultrasound guidance!

Due to the extremely small “poke” incision on the wrist, without an incision on the palm, the same release and relief of symptoms can be done “inside-out” while shortening the period of healing pain after the surgery. With ultrasound-guided carpal tunnel release, most 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 heavy or repetitive labor.

Since 2022, 50% of patients treated by Dr. Johnny T. Nelson, MD have both carpal tunnels released at the same time!

If you have carpal tunnel on both sides and you are ready to be free of your symptoms, ultrasound-guided carpal tunnel release on the same day for both hands is often the best option for you. But remember, every patient is different! Your treatment plan depends on a one-on-one consultation with Dr. Johnny T. Nelson MD, North Carolina Carpal Tunnel Specialist. Call 919-872-5296 for an appointment.

Can I Have Carpal Tunnel Release On Both Sides At Once? Read More »

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.

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

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!

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

Is Bruising Normal After Carpal Tunnel Release?

Carpal tunnel, Hand Surgeon, Sonex, Ultrasound

bruising Raleigh North Carolina Carpal Tunnel Release Expert Johnny T. Nelson, MD hears this question often. If you are asking this question, you are not alone and chances are you recently had a carpal tunnel release procedure. Perhaps you had a traditional open carpal tunnel release, or perhaps you had the ultra-minimally invasive carpal tunnel release with real-time ultrasound guidance.

So is bruising normal?

The short answer to the question is: Yes! Bruising is simply the human body’s response to surgery.

When Dr. Johnny T. Nelson, MD performs a carpal tunnel release, the human body and the skin, bones, and ligaments in the area do not “understand” what surgery is. To these structures, surgery is seen as an injury. In response to this, it is normal for the human body to bring fluid, blood, swelling, and redness to the area and response to the surgery. This is normal.

But what is the bruising? Where does it come from?

Bruising is simply the body taking the blood and fluid from the surgery location and breaking it down in preparation for clearing it out and sending it back to your liver. Anyone that has fallen and sustained a “charley horse” or bad bruise understands this process. Right after the injury, the site overall looks quite normal except for some swelling and may be some redness. But the day after, and over the week following, bruising appears. It is common for bruising to turn different colors, often going from purple to brown to yellow. Eventually it will fade away completely, which is a sign that the body’s immune cells have eaten up and cleared away the blood cells that were left behind.

What if I have bruising on my palm and on my forearm? What if the bruising is spreading?

This is also common after carpal tunnel release surgery. It is very normal to have bruising in the palm as well as over the front of the forearm, at times even extending into the fingers or towards the elbow. This does not mean that anything is wrong. Some patients may even have bruising visible on the top of the hand or forearm. It is also normal for the bruising to start close to the site of surgery and grow in size over the days and weeks following the procedure.

Why do some patients have more bruising than others?

This is difficult to understand. Some patients do not bruise at all after carpal tunnel release. Some patients bruise more, there are many reasons for this but most remain unclear. Some patients are on blood thinners, and these patients should expect to have more bruising. Again, this does not mean that there is a problem.

You have carpal tunnel syndrome? Do you wake up at night, shaking her hands out? Do your hands fall asleep during the day when performing certain activities? If so, call 919-872-5296 to schedule an appointment with Dr. Johnny T. Nelson, MD, North Carolina Carpal Tunnel Specialist.

Is Bruising Normal After Carpal Tunnel Release? Read More »

When Can I Return to Work After Carpal Tunnel Release?

Carpal tunnel, Hand Surgeon, Sonex, Ultrasound

When can I return to work after carpal tunnel release?

This is the most common question patients ask while discussing carpal tunnel release surgery with their doctor. It is a very important question. Our ability to work is one reason to consider carpal tunnel release, since carpal tunnel syndrome can severely affect your ability to use your hands and work well. Our ability to work is how we pay rent, feet our families, and one way to find fulfillment in life.

But many patients avoid having carpal tunnel release!

This is understandable and not very surprising. After talking to friends, family, and co-workers who have had older forms of carpal tunnel release, many are afraid of how much time they will need to take off of work. They also worry about the pain of the healing process and the physical therapy that will be needed. But this fear is often caused by a misunderstanding of how quick, comfortable, and targeted modern carpal tunnel release techniques are!

Raleigh North Carolina Carpal Tunnel Specialist Dr. Johnny T. Nelson offers carpal tunnel release under ultrasound guidance.

This requires only a small pea-sized “poke” over the wrist (not the palm), no IV or anesthesia is required, no painful tourniquet is required. Also, both sides often are performed on the same day if you have carpal tunnel syndrome in both hands. See here for a video where Dr. Nelson explains the healing after this procedure. Unlike other traditional methods of releasing the carpal tunnel, this technique does not require a long open incision in the palm or across the wrist. The “old” technique does work to relieve carpal tunnel symptoms, but there are “innocent bystanders” caught in the action. Skin and tissue is unnecessarily cut through and makes performing release on both sides too painful. With the ”old” technique patients often need therapy or weeks or months off of work.

Okay, that sounds good, but with the new technique, how much time off do I need?

First of all, the amount of time you need off of work really depends on what you do for work. Dr. Johnny T. Nelson does not usually restrict your activities after carpal tunnel release. This is because most activities, even heavier activities will not “ruin” the work that was done. It is however good to wait 3-5 days before doing very heavy gripping such as yard work, heavy tools, and lifting weights. This allows the hands to “cool down,” after the procedure.

It is also important to understand that every patient is a little bit different and heals differently. There is no “one size fits How to Stop Hand and Wrist Pain When Typing all” healing after carpal tunnel release. Some patients are comfortable enough to perform heavy gripping, pushing, and pulling 3 days after carpal tunnel release, while some patients those activities may take several weeks to return. Many plumbers, electricians, and mechanics have their carpal tunnel release on a Thursday, and are back to work the following Monday! In a few patients, return to full grip and pinch strength may take 1-2 months.

If you work at a desk during the day, and perform other light activities such as answering phones and handling papers and light paperwork, you can return to work immediately, even the day after the procedure.

If you perform repetitive activities, such as assembly line, cutting fabric, factory work, or hairdressing, you may need to take more time off of work, such as 2 to 4 weeks. Again, this is not because your job will interfere with your healing or ruin the surgery, but because you may be uncomfortable performing repetitive activities all day long. Most patients with these types of jobs are able to return with restrictions right away, or “play things by ear” and returned to work when they feel good enough.

There are special jobs where patients need more time due to the nature of their work. For example, police officers do and perform certain activities that need to be 100% expertly performed before they can return to work. The same applies to lifeguards.

Do you have carpal tunnel syndrome? Are you worried about how long you will need to stay out of work? Call 919-872-5296 today to schedule a visit with Raleigh North Carolina Carpal Tunnel Specialist Dr. Johnny T. Nelson, MD. He will discuss your condition and situation in detail and together you will form a plan on how to treat your carpal tunnel symptoms with minimal interruption to your life and work.

When Can I Return to Work After Carpal Tunnel Release? Read 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.

Announcing: January 10th Carpal Tunnel Open House Read More »

hand surgeon

What Are the Risks of Carpal Tunnel Release?

But you may still feel nervous about having surgery!

If your problem is carpal tunnel syndrome, North Carolina Carpal Tunnel Specialist Dr. Johnny T. Nelson, MD is the well-trained specialist for you!

Carpal tunnel release with ultrasound guidance helps to make sure that the risk is as small as possible!

Can I Have Carpal Tunnel Release On Both Sides At Once?

But what do I do when carpal tunnel on both sides does not get better?

But with new technology and a technique offered by North Carolina Carpal Tunnel Specialist Dr. Johnny T. Nelson, MD, this is no longer the case.

However, Dr. Johnny T. Nelson is an expert in the treatment of carpal tunnel syndrome under ultrasound guidance!

Since 2022, 50% of patients treated by Dr. Johnny T. Nelson, MD have both carpal tunnels released at the same time!

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!

So is bruising normal?

But what is the bruising? Where does it come from?

What if I have bruising on my palm and on my forearm? What if the bruising is spreading?

Why do some patients have more bruising than others?

When can I return to work after carpal tunnel release?

But many patients avoid having carpal tunnel release!

Raleigh North Carolina Carpal Tunnel Specialist Dr. Johnny T. Nelson offers carpal tunnel release under ultrasound guidance.

Okay, that sounds good, but with the new technique, how much time off do I need?

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

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