Carpal Tunnel

Overview

This is the most common nerve compression that leads to nocturnal numbness, tingling and shooting pains in the thumb through the radial half of the ring finger. In addition, patients can have issues with dropping objects as the muscles of the thumb used for pinch are weakened. After reviewing the patient’s symptoms and performing provocative maneuvers associated with carpal tunnel syndrome, the patient is generally sent to obtain nerve tests to determine the severity of carpal tunnel syndrome.

Combining the patient’s history/physical exam with the nerve tests, we work with the patient to determine what options would be best for management. The vast majority are treated conservatively with braces, steroidal injections, or a combination of the two. Those who meet surgical criteria are taken to surgery usually after failing conservative management. Our practice prides ourselves on not rushing all patients to surgery.

Dr. Anup Patel Advantage

Dr. Anup Patel performs decompression of nerve compressions including some of the rarest syndromes encountered in the upper extremity. Trained by Dr. David T.W. Chiu, a pioneer and leader in microsurgery and nerve disorders, and Dr. John Persing, a pioneer and leader in neurosurgery, Dr. Patel often employs microsurgical techniques with precise dissection to relieve pressure on the nerves.

Dr. Chiu and Dr. Patel were recognized on the Tonight Show for their work in treating the peripheral nerve compression of Jimmy Fallon. Dr. Patel routinely treats patients from around the world suffering from nerve issues causing pain, sensory disturbances, and motor function loss.

Dr. Anup Patel performs carpal tunnel surgery by placing the incision extremely far away from the median nerve (on the ulnar aspect) to minimize scarring on the nerve. This diminishes the risk of recurrence.

He uses loupe magnification to release the nerve completely ensuring that there is no compression at the end of the case that diminishes the risk of an incomplete release. Finally, using plastic surgery techniques, he closes the skin to provide an almost imperceptible scar.

Please see our YouTube channel for an intraoperative experience of how Dr. Anup Patel delivers some of the best carpal tunnel surgical outcomes. Do not take our word for it, but see our patient examples accompanied by testimonials.

Symptoms

  • Numbness, tingling, weakness, paresthesias and pain radiates from the elbow to the tips of the ring and small finger
  • Motor weakness leading to clawing of the ring and small fingers, loss of thumb pinch, and inability to bring the small finger to the hand
  • These symptoms may become worse at night and/or when the elbow is flexed (e.g., talking on a phone)


Causes

  • Compression of the ulnar nerve in the cubital tunnel (elbow) that can lead to ischemia of the nerve


Treatment: Non-Surgical

  • Elbow brace
  • NSAIDs


Treatment: Surgical

  • Release of the cubital tunnel with possible transposition of the nerve

Patient 1

70 year old female presents with severe, long-standing carpal tunnel syndrome with issues in terms of sensory and motor function. She underwent open carpal tunnel release with the technique used by Dr. Patel to minimize scar formation on the median nerve. Two months later she has full sensation and motor strength with minimal scarring.

Patient 2

68 year old male presents with severe, long-standing carpal tunnel syndrome with issues in terms of sensory and motor function. He underwent open carpal tunnel release with the technique used by Dr. Patel to minimize scar formation on the median nerve. Two months later he has full sensation and motor strength with minimal scarring.

Patient 3

32 year old female, semi-professional golfer presents with severe, long-standing carpal tunnel syndrome with issues in terms of sensory and motor function. She underwent open carpal tunnel release with the technique used by Dr. Patel to minimize scar formation on the median nerve. Two months later she has full sensation and motor strength with minimal scarring.

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Dr. Anup Patel

Dr. Anup Patel is a board-certified plastic and reconstructive surgeon trained in aesthetic, hand/upper extremity and reconstructive surgery. He completed his plastic and reconstructive surgery training at the premier Yale University followed by a hand and microsurgery fellowship at the New York University Institute of Reconstructive Plastic Surgery and Mount Sinai Department of Orthopedics. Dr. Patel received his MD and MBA from the Yale University School of Medicine and Yale University School of Management, respectively. He graduated as the valedictorian of his class at the University of Florida majoring in economics, biochemistry and molecular genetics and valedictorian of his high-school class at Lake Highland.

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