Carpal tunnel syndrome is a common condition, affecting wide range of individuals. While some people are able to manage the symptoms, others find it increasingly debilitating. In the case of the latter, certain interventions may provide relief.

Dr. Jonathan Cotton, Orthopedic Surgeon at Riverside Healthcare, offers insights into carpal tunnel syndrome—including symptoms, treatment options, and advancements in procedures.

What Does Carpal Tunnel Feel Like?

Carpal tunnel syndrome manifests as a constellation of symptoms that include numbness and tingling in a specific set of fingers (thumb, index, middle finger, and part of the ring finger), as well as a burning sensation at times. These symptoms tend to occur at night and are often severe enough to wake people. However, many patients also experience symptoms from repetitive activities.

“Most people have found their hand to go numb intermittently, whether it’s holding a newspaper or a tablet or driving. If it’s more persistent and really affecting their quality of life, it’s time to start seeking treatment,” states Dr. Cotton. “The nice thing is, surgery to relieve carpal tunnel syndrome has gotten so much better. I think a lot of patients are not having to suffer as much and they’re not as scared about the procedure.”

Sonex: In-Office, Minimally Invasive Procedure

Traditional carpal tunnel surgery involves making an incision on the wrist, which requires the patient to be under anesthesia. Recovery can be complex, because people use their hands for so many activities throughout the day. Diagnosis is also somewhat painful, as it involves an EMG—which is essentially inserting needles into different muscles and then shocking the patient to detect slowed nerves.

A new option, called Sonex, is an in-office carpal tunnel procedure. “This struck me as a minimally invasive procedure that could really enhance people’s recovery and shorten their need for pain medication,” notes Dr. Cotton.

Sonex uses ultrasound technology to measure the median nerve. If it’s determined that carpal tunnel is at play, the procedure that follows is a small incision on the wrist with only local anesthetic.

“Using the ultrasound, we make sure the anatomy is favorable and everything is safe. The device has a very small knife blade that actually cuts the ligament that’s constricting the nerve from the undersurface. That opens up the space in the carpal tunnel and now that nerve is not being compressed,” explains Dr. Cotton. “The whole procedure takes about 20 minutes for a single wrist.”

Patients can drive themselves home and typically do not require pain medication. “Sometimes, we’ve had manual laborers go back to their job at three days,” he adds.

In some cases, patients also have another nerve compression syndrome called cubital tunnel, which is compression of the ulnar nerve at the elbow. The procedure to address this syndrome must still be done in the traditional manner. However, the company that makes the current Sonex device carpal tunnel is working on a device for the elbow as well.

Success with Sonex

Dr. Cotton has been thrilled with the results his patients have achieved with the Sonex procedure. He recalls one particular success story where a patient had the procedure on a Friday and golfed the next day.

“He said it was the best golf he’d ever had because he could finally feel the golf club,” he shares. “With the standard surgery, the recovery is quite long. There’s a lot of pain. With the Sonex procedure, the numbness and tingling gets better almost immediately. And because there’s so little pain to worry about, patients are satisfied very early.”

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