Carpal Tunnel Syndrome

Let the experts at Hoag Orthopedic Institute Help

Do I have Carpal Tunnel?

Carpal tunnel, or median nerve compression, is a numbness, tingling or weakness in the hand and arm caused by a pinched nerve or pressure on your median nerve. Carpal tunnel can be caused by over-use or repetitive motions (like typing) and is more commonly seen in women (3:1). Carpal tunnel is caused by a lack of space and blood flow to the median nerve area causing numbness and radiating pain in the hand, wrist and forearm area. Over time, carpal tunnel can also affect hand strength and ability to grasp things with the hand effectively. This can affect your ability to do daily activities.

There is a higher incidence of having carpal tunnel as we age, peaking in patients that are 50 or 60 years of age. There is also a strong correlation with patients that have a higher body mass index (BMI). Other risk factors include: Diabetes, hyperthyroidism, rheumatoid arthritis and pregnancy.

Symptoms of Carpal Tunnel

Carpal tunnel causes numbness and pain in the hand, wrist and forearm area. If you are experiencing some of the symptoms below, please contact a hand surgeon at Hoag Orthopedic Institute and schedule an appointment.

Numbness and tingling in the hand (median nerve sensory distribution)
Pain radiating in the hand, wrist and up the arm
Symptoms worsen with increased activity (causing increased pressure to the median nerve)
Decreased fine motor skills in the hand and wrist (difficulty buttoning a shirt or opening a jar)
Weakness in your hands, difficulty holding things
Cold intolerance, dryness, and unusual textures in the fingers (radial digits) signify disruption of the sympathetic fibers carried by the median nerve
Pain worsens during sleep

Why does carpal tunnel pain worsen during sleep?

During sleep we often flex our wrist, which increases pressure on the median nerve
Blood Pressure decreases during sleep, causing poorer nerve perfusion
Due to the inactivity during sleep, we are no longer “pumping” fluid out of the wrist

Diagnosis of Carpal Tunnel

When you come to Hoag Orthopedic Institute (HOI) for a physical exam, your hand doctor will consider many factors before diagnosing carpal tunnel, including how your symptoms developed.

During your physical exam, your orthopedic doctor will use a variety of diagnostic tests to pinpoint what exactly is causing your hand and arm pain, including:

Observation for thenar atrophy (late)
Sensory testing
Motor testing (APB muscle)
Provocative testing via media nerve compression
Electrodiagnostic studies
Phalen’s test of wrist flexion
Tinel’s test (recreates tingling sensation in the sensory distribution of the median nerve)
Compression test (a positive test recreates tingling or numbness within 30 seconds in the median nerve distribution)
Nerve test (Electromyogram EMG) directly records from the muscles and measures severity of nerve dysfunction

Non-Surgical Carpal Tunnel Treatment

The goal of treating hand and wrist pain caused by carpal tunnel is to effectively decrease pressure and improve blood flow to the median nerve. The following non-surgical treatments can help alleviate this pressure.

Night-time splint: keeps the wrist in a neutral position to help prevent wrist flexion during sleep
Vitamin B6: 100mg – 200mg once a day
Steroid injections decrease inflammation and swelling and can relieve pressure and improve blood flow to the median nerve

Surgical Carpal Tunnel Treatment

Since continued carpal tunnel can result in permanent nerve damage, if conservative treatments do not relieve your hand and wrist pain your hand surgeon may recommend carpal tunnel surgery. Carpal tunnel surgery increases the space surrounding the media nerve by sectioning the transverse carpal ligament and opening up the volar aspect of the carpal tunnel. Options for carpal tunnel surgery include:

Open Release Carpal Tunnel surgery
Endoscopic directed release carpal tunnel surgery
Minimal incision release carpal tunnel surgery

Schedule a consult today with a hand surgeon to determine the best treatment option for your specific case.

What to expect from Open Release Carpal Tunnel Surgery?

Since the open release method for carpal tunnel surgery has a 95% or higher success rate¹, let’s discuss w what you can expect from this procedure.

30-minute surgery at an outpatient surgery center
Less than a 1-inch incision
2-3-week recovery
May use your hand gently immediately following surgery

Find a Hand & Wrist Doctor

Why Choose Hoag Orthopedic Institute for Carpal Tunnel Care

Our board-certified, fellowship-trained hand surgeons are experts at treating carpal tunnel and other hand and wrist conditions.

Do you have a hand or wrist injury? Contact Hoag Orthopedic Institute to find a hand and wrist expert at (949) 890-0464 .

Frequently Asked Questions

At your first visit, your orthopedic hand and wrist specialist will take time to understand your symptoms, medical history, and lifestyle. Expect a detailed conversation about when your symptoms began, what movements or activities make them worse, and what treatments you’ve already tried.
Your hand doctor may perform a physical exam and order advanced imaging, such as X-rays, ultrasound, or MRI, to help pinpoint the source of your pain or dysfunction. Once a diagnosis is confirmed, your specialist will walk you through all treatment options, from non-surgical care to potential procedures.
Most importantly, you’ll receive clear answers to your questions and a personalized plan designed to support your goals and restore hand and wrist function.
Scheduling an appointment with a qualified hand doctor at Hoag Orthopedic Institute is quick and easy. You can request a consultation online or call our scheduling team directly at (949) 890-0464 to speak with a team member. Our team will help match you with the right hand specialist for your condition, preferences, and availability.
From your very first visit, our team prioritizes clear communication and personalized care. Your orthopedic hand doctor will take the time to fully understand your needs as well as answer all your questions, explain your condition, and walk you through your treatment options.
Whether you need an initial diagnosis or a second opinion, you’ll have access to board-certified orthopedic hand surgeons, advanced diagnostic tools, and personalized care planning.
At Hoag Orthopedic Institute, our expert hand doctors and orthopedic hand and wrist specialists provide a thorough evaluation to determine the least invasive treatment that meets your needs. Non-surgical care may include activity modification, bracing, corticosteroid injections, ultrasound, and targeted physical therapy — all designed to relieve pain and restore function.
When surgery is your best path forward, our fellowship-trained orthopedic hand surgeons perform advanced procedures ranging from minimally invasive endoscopic carpal tunnel release to complex tendon, ligament, and joint reconstructions. Many operations are performed with robotic assistance and arthroscopic tools to support faster healing and better long-term outcomes.
Whether your pain and dysfunction are caused by arthritis, nerve compression, or a traumatic injury, our orthopedic hand doctors tailor your treatment plan to get you back to doing what you love.
At Hoag Orthopedic Institute, your care is led by nationally recognized orthopedic hand doctors and fellowship-trained hand and wrist specialists who use the most advanced surgical and non-surgical techniques available today. From robotic-assisted procedures to minimally invasive surgery, our orthopedic hand and wrist surgeons focus on achieving the best possible outcomes with less pain and faster, more complete recovery.
Every patient benefits from personalized treatment planning, cutting-edge diagnostics, and a compassionate, collaborative care team. Whether you need a hand surgeon for complex trauma or a hand specialist treating chronic joint pain, Hoag Orthopedic Institute delivers exceptional, patient-centered care you can trust.
Our highly trained hand doctors and specialists provide expert treatment designed to meet your specific needs and goals.

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