One small incision.
Ten minutes.
Finally sleeping through the night.

The classic presentation is highly specific: nocturnal numbness and tingling in the thumb, index, middle, and part of the ring finger (the median nerve distribution), relieved by shaking or hanging the arm. Numbness in the little finger suggests ulnar nerve involvement rather than carpal tunnel. Weakness and numbness in the entire hand or arm may suggest a cervical spine cause (cervical radiculopathy). The diagnosis is confirmed with nerve conduction studies (NCS) and electromyography (EMG), which measure the speed of nerve conduction through the carpal tunnel. A consultation with Dr. Katsevman includes a physical exam and review of your nerve studies to confirm the diagnosis before any surgical recommendation is made.

Night splints work by keeping the wrist in neutral position during sleep, preventing the flexion that compresses the nerve. When splints no longer provide adequate relief, it typically indicates that the compression has progressed beyond what positional management can address — either because the tunnel is significantly narrowed at all wrist positions, or because the nerve has sustained injury that requires decompression to recover. At this stage, nerve conduction studies are appropriate to quantify the degree of compression and nerve damage, and a consultation to discuss surgical options is reasonable. The longer significant compression continues without decompression, the greater the risk of permanent nerve injury.

Yes — multiple randomized controlled trials and large systematic reviews have confirmed equivalent rates of symptom relief and median nerve decompression between endoscopic and open carpal tunnel release. The primary advantages of endoscopic release are reduced incision size, preservation of the palmar fascia, less pillar pain, and faster return to full activity. For patients concerned about recovery speed, grip strength recovery, or occupational return-to-work timing, the endoscopic approach is generally preferred. The Arthrex Nanoscope system allows complete visualization of the ligament during release, ensuring the same completeness of decompression as open technique.

For most patients, nocturnal numbness improves immediately — many report sleeping through the night for the first time in months on the night of surgery itself. Daytime tingling and finger numbness typically improve over days to weeks as the nerve recovers from compression. Full sensory recovery in mild to moderate cases usually occurs over 6 to 12 weeks. Severe cases — with prolonged compression, measurable weakness, or visible thenar wasting — may take longer and may not achieve complete recovery if nerve damage was significant before surgery. This is one of the reasons early surgical intervention is preferable to prolonged observation when conservative management is failing.

Bilateral carpal tunnel syndrome is common and both sides can often be addressed. Whether both are done simultaneously or staged (one side, then the other a few weeks later) depends on the severity of each side and practical considerations — having both hands in recovery at once can make daily activities difficult in the immediate post-operative period. Many patients prefer to do the more symptomatic side first, confirm the result, and then schedule the second side. This is discussed during the consultation based on your specific situation and the degree of symptoms on each side.

Most patients leave the surgical center the same day with a small bandage at the wrist — not a full cast. The wrist is sore at the incision site for a few days, managed with over-the-counter pain medication. Light use of the hand is possible within days. Driving typically resumes within 1 to 2 weeks. Full grip strength and return to heavy activity or manual work typically occurs within 2 to 4 weeks — significantly faster than the 4 to 8 weeks often associated with open carpal tunnel release. Physical therapy is rarely needed for straightforward cases.