At Oregon Cosmetic and Reconstructive Clinic, I meet many patients who are scared or unsure about their hand symptoms. I like to break things down simply, because understanding what’s happening in your body often makes everything feel less stressful.
Carpal tunnel syndrome is a perfect example. It’s common, it’s treatable, and—when caught early—we can usually help people get back to their daily activities quickly.
What Is Carpal Tunnel Syndrome?
Carpal tunnel syndrome happens when the median nerve gets squeezed where it travels through a narrow space in your wrist called the carpal tunnel. When this space becomes tight, the nerve struggles to work normally.
Common Symptoms
Patients often describe:
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Numbness or tingling in the thumb, index, middle, and half of the ring finger
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Nighttime symptoms that wake them up
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Pain that shoots into the forearm
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Weak grip or dropping objects
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Difficulty buttoning clothes or typing comfortably
These symptoms usually feel worse when the wrist bends, because that increases pressure inside the carpal tunnel.
Mild Carpal Tunnel: What I Recommend First
I like to start with simple, low-risk treatments whenever possible. For most mild cases, I recommend:
Night Splinting
Wearing a neutral wrist splint at night keeps the wrist from bending. Since many people sleep with their wrists curled, a splint prevents that extra pressure on the median nerve.
Splinting works well for early symptoms, and many patients start seeing improvement within a few weeks.
What About Steroid Injections?
I usually avoid steroid injections except in one special situation:
carpal tunnel syndrome during pregnancy.
During pregnancy, swelling can increase pressure around the nerve. A small steroid injection can offer relief until the swelling naturally improves after delivery. Because these cases often resolve on their own once the patient is no longer pregnant, surgery is rarely needed.
When Surgery Becomes the Right Choice
If symptoms continue despite splinting—and nerve testing shows compression—I usually recommend surgery. Surgery works by releasing the tight ligament that presses on the nerve. We don’t operate on the nerve itself; we simply give it enough space again.
Open vs. Endoscopic Surgery
There are two main approaches:
1. Endoscopic Release
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Scar in the wrist crease
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Camera views the underside of the ligament
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The median nerve itself is not directly seen
2. Open Carpal Tunnel Release (My Preferred Approach)
I perform the open technique because it gives me a clear and direct view of the nerve. This allows me to safely release the ligament while protecting the structures around it.
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Scar is usually less than one inch and placed in the palm
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I can see the median nerve directly
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Reliable and predictable results
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Fast recovery for most patients
For me, seeing the nerve clearly is important. Because I’m releasing the tight ligament—not the nerve itself—my goal is to create space so the nerve can recover at its own pace.
What to Expect After Surgery
Most patients are surprised by how quickly they feel relief.
Recovery Timeline
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Within the first week:
Many people already notice that their nighttime numbness or tingling has improved. -
Up to 1 year:
In very severe cases—especially if symptoms have been present for years—the nerve may take longer to fully recover. Improvement can continue gradually over months. -
2 weeks:
Stitches are removed. -
First month:
Light hand activity is safe, such as typing, holding a phone, self care, or opening light doors. -
After 1 month:
You can resume heavy gripping, lifting, and more strenuous hand use.
I guide each patient through recovery step by step, and I tailor activity recommendations based on how their nerve is healing.
If you’re curious about other procedures I perform, you can explore my hand surgeries on the clinic website.
