Carpal tunnel syndrome, or CTS, is a common condition that affects an estimated 12 million people in the US, with an additional 2.1 million diagnosed every year.

Carpal Tunnel Syndrome (CTS) is a common condition that causes pain, numbness, and tingling in the hand and arm. The condition occurs when one of the major nerves in the hand—the median nerve—is compressed as it travels through the wrist. The median nerve controls movement in the thumb and feeling in the thumb and first three fingers. It runs down the arm and forearm, passes through the carpal tunnel at the wrist, and goes into the hand.

• Tingling or numbness. You may notice tingling and numbness in your fingers or hand. Usually the thumb and index, middle or ring fingers are affected, but not your little finger. You might feel a sensation like an electric shock in these fingers.The sensation may travel from your wrist up your arm. These symptoms often occur while holding a steering wheel, phone or newspaper, or may wake you from sleep.
• Weakness. You may experience weakness in your hand and drop objects. This may be due to the numbness in your hand or weakness of the thumb’s pinching muscles, which are also controlled by the median nerve.

Carpal tunnel release surgery has been a well known and proven treatment for relieving the pain associated with carpal tunnel syndrome for many years. Ultrasound guided minimally invasive release surgery was introduced in 1997, and today has been optimized with safe, FDA approved surgical device equipment. Using ultrasound has the added advantage of allowing the physician to see the internal structures of the wrist in real time during the procedure, increasing the efficacy and accuracy of the release. Using microsurgery techniques allows for the release to be done in an office or outpatient setting, taking minutes to complete and needing only local anesthesia. Because the procedure is minimally invasive, the incision is small, no sutures are needed and the recovery time is much faster. Studies show most patients can return to their normal activities within 3-6 days.

After numbing the wrist with lidocaine, a 2-3 mm incision is made in the wrist allowing for safe passage of the microknife device under the transverse carpal ligament under real time ultrasound guidance. A balloon expansion gently pushes away the median nerve and surrounding vessels, allowing for the transverse carpal ligament to be safely cut. Following the cut, the median nerve is released, pressure to the nerve is reduced and symptoms to the wrist and hand are improved. The video shows a brief graphic demonstration of the procedure.

There are 3 types of carpal tunnel release; open, endoscopic and ultrasound guided minimally invasive. All three have the same goal of releasing the median nerve by cutting the transverse carpal ligament. The following chart compares the three approaches. While the end result is the same, there are procedural and post-procedural differences in safety, recovery time, and possibilities of hand usage suggesting a significant benefit with ultrasound guided minimally invasive carpal tunnel release.

CTR surgery is covered by most private insurance companies.   Patients who have HSA accounts are eligible to use them to pay out of pocket portions. Patients should always confirm coverage with their provider prior to treatment.

The graph below shows an estimated out-of-pocket expense and is based on a National blended average of commercial insurance

1. National average commercial payment rates based on Optium claims database
2. Assumes $2500 deductible at 20% co-pay
3. Individuals actual expense will vary depending on plan. 

Ask us about other possible reimbursement options.