The most common entrapment nerve problem is carpal tunnel syndrome.
The carpal tunnel is a tightly enclosed space in the wrist bounded by a floor of eight wrist bones and a roof consisting of a tough piece of fibrous tissue called the transverse carpal ligament.
Through this tight space pass the flexor tendons of the hand as well as the median nerve.
Carpal tunnel syndrome results from excessive pressure buildup in the carpal tunnel leading to compression of the median nerve in the wrist. Patients complain of numbness and tingling in the hand, primarily the thumb and first two fingers. Repetitive motion such as checking produce, knitting, and other similar activities can cause carpal tunnel syndrome. This malady is also associated with medical conditions such as an underactive thyroid gland, acromegaly (excessive growth hormone), rheumatoid arthritis, and pregnancy.
The conservative method of treating this problem is a program incorporating wrist splints, anti-inflammatory medicines, exercises, and physical therapy.
Patients who don’t respond to this approach may benefit from an ultrasound guided steroid injection.
Patients who failed these measures in the past would automatically be sent for a surgical release, meaning cutting the transverse carpal ligament with a knife- either open surgery or using an endoscope.
A new technique for carpal tunnel release using ultrasound guidance and a special metal impregnated thread has been shown to work as effectively as the standard surgical treatment but with no pain, many fewer complications, and virtually no down time.
The procedure uses a local anesthetic, a proprietary metal impregnated thread, and a specially designed needle to cut through the transverse carpal ligament, the tough fibrous band that causes restriction in this tight space. The needle and thread are manipulated using ultrasound guidance.