Carpal tunnel syndrome (CTS) is the most common nerve compression syndrome—so much so that, according to the National Center for Health Statistics, at least 1.89 million people suffer from the condition.

CTS occurs when the median nerve in the wrist’s narrow carpal tunnel becomes compressed by surrounding soft tissue. This compression reduces blood flow to the nerve and contributes to symptoms that include burning, tingling and numbness in the thumb and index and middle fingers. Pain in the forearm is also a common complaint.

Symptoms typically start during sleep when the wrists are flexed and/or extended for long periods of time. People will awake with pain and numbness. “In long-standing severe cases, patients may find themselves dropping things and losing dexterity and their sense of fine touch." says Dr. Robert Boretz, a board certified orthopedic and hand surgeon.

There are many risk factors for CTS, including diabetes, thyroid disease, pregnancy, inflammatory arthritis and repetitive stress. CTS can develop in either one or both wrists and worsen dramatically over time. While it often starts out as an “inconvenience” that disrupts sleep, without treatment it typically progresses to persistent pain and loss of function.

Therapeutic intervention usually begins with immobilizing the wrist with a splint at night. For moderate cases, corticosteroid injections may be used but are temporizing. Surgery is recommended as a curative measure for severe cases and when conservative treatments have failed. The 20-minute outpatient procedure, called carpal tunnel release, involves cutting the ligament that forms the roof of the carpal tunnel to decompress the median nerve. It can be performed minimally invasive as a mini-open procedure or endoscopically.

"Both procedures have their advocates. However, they both are safe and effective and allow an early return to function and work" notes Dr. Boretz, who does upward of 200 carpal tunnel releases annually. "Nighttime symptoms will resolve the day of surgery, but if there is fixed sensory change, this can improve unpredictably."

At the Center for Orthopedic Care, Dr. Boretz uses the latest surgical technologies and techniques to perform both complex and minimally invasive procedures. His practice specializes in the treatment of the entire upper extremity. “What’s important for people suffering from CTS to know is that it is easily treatable, with very low complications and a high success rate. In general, the earlier they seek treatment, the better result they’ll have.”