Carpal tunnel syndrome

A common cause of peripheral nerve damage is a result of entrapment of a nerve from overgrowth of the overlying ligaments. The nerve is repeatedly traumatized by compression from the overlying ligament and thereby results in chronic pain, weakness, and numbness.

Carpal tunnel syndrome is the most common entrapment neuropathy that occurs in the wrist. The common symptoms of carpal tunnel syndrome include pain as well as numbness at the wrist and hand involving the fingers. If symptoms persist for long enough or if there is severe compression, there could also be weakness of certain hand muscles.

The best way to diagnose carpal tunnel syndrome is via a study known as nerve conduction velocity study which will detect slowed response of the median nerve at the level of the wrist. The treatment options include medications (usually nonsteroidal anti inflammatories), splinting the wrist, injections and surgery.

The surgery to relieve pressure from the median nerve requires the removal of the carpal ligament overlying the nerve. We do this by using a specialized knife that requires only a small incision over the wrist. The surgery usually takes less than 30 minutes and patients go home several hours after the procedure.

Cubital tunnel syndrome

Cubital tunnel syndrome is the second most common entrapment neuropathy secondary to carpal tunnel syndrome. Cubital tunnel syndrome is the entrapment of the ulnar nerve at the elbow by the ligaments that span the bones of the elbow.

The common symptoms of cubital tunnel syndrome are pain in the middle of the forearm and numbness of the pinkie and ring fingers. Symptoms can also include weakness to the muscles of the hand.

The symptoms are usually aggravated with flexion of the elbow in situations such as driving in which the ligaments are made tight and compress the nerve. Cubital tunnel syndrome is also best diagnosed via a nerve conduction velocity study which shows slowing of electrical response across the nerve at the level of the elbow.

Treatment options include medications (usually nonsteroidal antiinflammatories), injections, and surgery. The surgery incision spans the elbow and extends several centimeters around the elbow. The nerve is identified and the ligaments overlying it are removed. The surgery takes less than an hour and patients go home several hours after the procedure.