Carpal Tunnel Hydro-Dissection


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The pain associated with Carpal Tunnel Syndrome (CTS) can be very disrupting to one's activity. Although there are different causes of wrist pain, Carpal Tunnel Syndrome is one of the more common causes. True Carpal Tunnel Syndrome is associated with compression of the Median Nerve in the area of the wrist known as the Carpal Tunnel. The result of this is numbness, pain, and difficulty with grip. CTS is associated with smoking, diabetes, hypothyroid, and other conditions. A genetically smaller canal than average may also predispose the patient to developing CTS.

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Treatments include supplementation with Vitamin B6 and B12, normalizing hormonal deficiencies, discontinuation of smoking, use of wrist splints at night while sleeping (to keep the wrists from bending too much and compressing the nerve), occupational therapy, and changes at the desk and workplace. Injections also frequently help if more conservative measures fail and have been used for many years, but may not provide a permanent solution. Injections using Ultrasound Guidance help avoid unnecessary risk and provide a precise approach to release the nerve from the nearby constrictions, providing a potentially better result than "blinded" injections alone.

A new procedure has been developed to treat CTS. Using Ultrasound Guidance, the nerve can be "hydro-dissected" from the neighboring tissues using a small needle. The transverse carpal ligament that covers the carpal tunnel can also be partially released with a needle tip to open up the tunnel. This is an in-office procedure that takes less than 30 minutes and leaves no significant scar. If these techniques are not successful enough, the patient may choose to have surgery to more completely separate the transverse carpal ligament.