How Carpal Tunnel Endoscopic Surgery Helps to Relieve Pain and Numbness

To someone who has never experienced carpal tunnel syndrome, it might not seem like a big deal. After all, we’ve all had wrist pain from time to time.

But those who suffer from carpal tunnel know that it goes much deeper than wrist pain. Our hands integral to our interaction with the world, and losing the use of one can have a detrimental impact on our quality of life.

Maybe you work in a job that requires you to use your hands. Maybe you struggle with beloved hobbies because of numbness and pain in your hands. Either way, you know that carpal tunnel is keeping you from living the life you want.

Carpal tunnel endoscopic surgery can help you recover from your carpal tunnel and take control of your life. Keep reading for a complete guide to how the surgery works and how it helps relieve symptoms of carpal tunnel.

What is Carpal Tunnel Syndrome?

First, let’s look at the mechanics behind your carpal tunnel. This will make it easier to understand how carpal tunnel endoscopic surgery can help.

The carpal tunnel is a narrow passage in the wrist. It is formed by three wrist bones and covered by the flexor retinaculum, a strong band of connective tissue. This tunnel houses the median nerve and nine tendons connecting the hand to the arm. These are used to move all your fingers except your pinky.

Carpal tunnel syndrome occurs when this passage narrows, causing the wrist bones to compress the median nerve and tendons.


Compression from the bones cuts off or muddles signals from your brain to your fingers. It also interferes with signals coming back, as well as the ability of your muscles to move your fingers in response to signals from the nerve.

Since the median nerve cannot operate properly, it gradually begins to lose function.

At first, you’ll notice that your thumb and first three fingers feel like they’re falling asleep–numbness, tingling, the sensation of pins and needles.

This can be distinguished from normal numbness because the sensation first shows up at night (due to the relaxed position of your hand while sleeping). You may also wake up to a sensation of numbness and tingling in your hands that may run up your shoulder. Shaking your hands normally relieves it.

Over time, though, this sensation becomes constant, and you may begin to struggle with weakness in the hands and difficulty completing tasks that require manual dexterity.

Severe cases of carpal tunnel can result in total loss of feeling in the fingers, slower nerve impulses, and a concurrent loss of strength and coordination in the fingers (particularly the ability to use your thumb and index finger to pinch).

Common Causes

It was once thought that carpal tunnel was solely the result of repetitive movements, with office work and typing cited as common culprits.

Now, doctors are inclined to think genetics plays a bigger role in carpal tunnel syndrome–some people are more anatomically inclined to wind up with carpal tunnel syndrome than others.

Women, in general, are more likely to get carpal tunnel because they naturally have narrower carpal tunnels.

However, there are many potential risk factors that can lead to carpal tunnel.

For example, fluid retention during pregnancy and menopause can also create a pressure change leading to carpal tunnel syndrome.

In addition, certain medical conditions leave you with an increased risk of developing carpal tunnel, including:

  • Diabetes
  • Osteoarthritis
  • Rheumatoid arthritis
  • Kidney failure
  • Thyroid conditions

A wrist dislocation or fracture can also create increased pressure on the carpal tunnel as the injury heals. Prolonged, repetitive work with a vibrating tool or using the wrist for certain repetitive motions (such as assembly line work) can also damage the carpal tunnel.

However, you shouldn’t confuse other hand-related injuries with carpal tunnel. The syndrome results from damage to the nerve in your wrist, not finger injuries or hand injuries.

Why Would You Need Carpal Tunnel Surgery?

With all of that said, not everyone who has carpal tunnel will get surgery. Not everyone needs it.

There are many ways to treat carpal tunnel syndrome, including:

  • Splints or braces
  • Corticosteroids
  • Changes to your daily routine
  • Hand therapy
  • Cortisone injections

Generally, if your carpal tunnel can be relieved using these methods, your doctor will try to use these first.

When Would Your Doctor Suggest Surgery?

In some cases, though, surgery is the only remedy.

If nonsurgical interventions have failed, your doctor may recommend carpal tunnel release surgery as an option. They may be especially concerned if they find that the muscles in your hand are actually becoming smaller and weaker due to your carpal tunnel syndrome.

In addition, if your carpal tunnel progresses for six months or more without improvement, then your doctor may recommend surgery in order to prevent additional damage to your nerve and tendons.

What is Carpal Tunnel Endoscopic Surgery?

If this sounds like your case, then surgery may be the best option for you.

Carpal tunnel endoscopic surgery uses a thin tube with an attached camera (an endoscope. With either a single-portal technique (guiding through a small incision in the wrist) or two-portal technique (incisions in the wrist and palm), the doctor uses the camera to see structures in your wrist without a large incision.

The camera will guide the surgeon as they use tiny cutting tools to cut the transverse carpal ligament.

This is an outpatient procedure that usually allows you to go home the same day. It requires a few months of recovery time, during which you’ll have reduced grip strength.

Your grip strength usually returns within two to three months but can take up to a year if your nerve impingement was severe.

Open vs. Endoscopic Surgery

There are two types of carpal tunnel release surgery:

  1. Open carpal tunnel release
  2. Endoscopic carpal tunnel release

The difference is simple.

Open carpal tunnel release surgery requires the surgeon to cut open your wrist using a larger incision and cut the transverse carpal ligament using normal surgical tools. Endoscopic carpal tunnel release uses smaller incisions and tiny cutting tools.

Because of this, endoscopic carpal tunnel release is far less invasive than open carpal tunnel release.

The Goal of Surgery

Regardless of the type of surgery, the goal is the same: to relieve pressure on the median nerve, restoring normal function to the affected hand.

Most of the time, this is achieved by cutting (releasing) the transverse carpal ligament in the palm of the hand. There are some rare situations where the cause of carpal tunnel is unusual (such as a growth in the carpal tunnel), in which case surgery would focus on removing the growth to relieve pressure.

However, surgeons do have to be careful about how they relieve pressure on the carpal tunnel. They have to cut the ligament completely without causing damage to the surrounding structures and nerves, as well as the surrounding soft tissues.

As such, the goal of surgery is twofold: to relieve pressure on the median nerve with minimal or no damage to the surrounding small nerves, ligaments, and soft tissue.

Significant complications, especially damage to small nerves, can lead to problems that may be worse than the original carpal tunnel syndrome.

How Carpal Tunnel Surgery Helps

Knowing how carpal tunnel syndrome works, and how carpal tunnel release surgery works, makes it easier to understand how the surgery helps relieve your symptoms.

Let’s take a closer look at how carpal tunnel endoscopic surgery can help relieve your pain and numbness.

Release Pressure

Excess pressure is the foremost problem in carpal tunnel syndrome–and thus the foremost goal of surgery.

The carpal tunnel is already a narrow passage in your wrist. The median nerve and ligaments are wrapped closely around each other to pass through the bones. As such, any change in the tunnel, whether it’s the alignment of the bones or in the ligaments, can create excess pressure on the median nerve.

Since carpal tunnel release surgery cuts the transverse carpal tunnel ligament, this immediately helps to relieve pressure on the median nerve, allowing the nerve to recover and restore normal functioning.

Decreased Pain

Because surgery releases pressure on the nerve, your nerve is immediately operating more effectively than it was before, even while you’re still healing from surgery.

You may have some pain as your ligaments and wrist heal from surgery. However, most people will notice a significant reduction in their carpal tunnel pain as the median nerve recovers.

After all, the pressure on your median nerve is decreased as soon as the ligament is cut, eliminating the source of the pain signals your hand was receiving.

Increased Strength

With carpal tunnel, strength is difficult to judge.

Since the median nerve is struggling to send, receive, and interpret sensation, it can be difficult for someone with carpal tunnel to know how tightly they need to grip something. And even if they can figure it out, it may be difficult to maintain the appropriate grip strength.

With pressure on the median nerve relieved, your nerve can return to normal functioning.

Remember, the nerve is healing just as much as the ligaments and skin (the central nervous system is difficult to heal, but the peripheral nervous system can heal if allowed to do so).

As such, while it may take some time, you can regain function in your hand.

However, there are severe cases of carpal tunnel that cause the muscles in your hand to atrophy. You may not see a full restoration of your original muscle function, but you can see significant improvements with time and physical therapy.

Improved Joint Mobility

Your nerves are involved in everything you do. They move your muscles almost instantaneously.

If a nerve cannot send messages properly, you may not be able to move through your full range of motion. This is especially true of carpal tunnel, where the effect is compounded by excess pressure in the wrist that prevents the wrist joint from moving.

As surgery restores function to your nerve and relieves pressure on your wrist, you may see increased mobility in your joints.

This may be in obvious places, like your fingers and wrist, but may also include other parts of your arm that you subconsciously limited in order to reduce strain on your wrist and hand.

Much like muscle strength, it will take time and physical therapy to see a complete restoration. But if you’re dedicated, you can absolutely see positive results after your surgery.

Noninvasive Surgery

Another benefit of endoscopic carpal tunnel release is that it’s a noninvasive procedure.

That might sound irrelevant at first. But in reality, it’s a huge deal for your recovery.

Larger surgical incisions basically translate to larger injuries that require healing. The difference between surgery and cutting yourself is that surgery is done intentionally in order to promote healing.

Anyone who’s ever been in surgery will tell you that larger surgeries take longer to recover from. Noninvasive surgeries like endoscopic carpal tunnel decrease your recovery time, allowing you to return to pre-carpal tunnel levels of functionality faster.

Do You Need Carpal Tunnel Endoscopic Surgery?

If you’re suffering from carpal tunnel syndrome that won’t respond to nonsurgical treatment, don’t let another day of your life go to waste.

We offer quick, noninvasive carpal tunnel endoscopic surgery and guarantee a fast recovery–and a 98% success rate.

If you’re ready to take your life back, click here for new patient information, or get in touch with us to discuss your options.

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The Hand Surgery Specialists of Texas offers diagnosis and treatment for hand, wrist, and elbow problems in Houston, using the most advanced and minimally invasive medical techniques. Our orthopedic hand specialists and hand and finger surgeons are waiting to provide you with excellent care at one of our hand care centers in River Oaks, Webster, North Houston, Katy/Sugarland, or Baytown

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