Los Angeles Hand Surgeon

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Animal and Human Bites
Arthritis at Base of Thumb
Brachial Plexus Injury
Carpal Tunnel Syndrome
Congenital Hand Differences
Cubital Tunnel Syndrome
De Quervain's Tendonitis
Dupuytren's Disease
Extensor Tendon Injuries
Fireworks Accident
Flexor Tendon Injuries
Ganglion Cysts
Hand Fractures
Hand Infections
Kienböck's Disease
Nail Bed Injuries
Nerve Injuries of the Hand
Osteoarthritis of the Hand
Prosthetics and Amputation
Reflex Sympathetic Dystrophy
Replantation
Rheumatoid Arthritis
Scaphoid Fractures
Scaphoid Non-Union
Tendon Transfer Surgery
Tennis Elbow
Thumb Sprains
Trigger Finger
Vascular Disorders
Wrist Arthroscopy
Wrist Fractures
Wrist Sprains


Diagnosis Model
Hand Diagnosis Model

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Call our offices at:
(310) 274-3481
(800) 964-0404

Beverly Hills
9301 Wilshire Boulevard
Suite 406A
Beverly Hills, California 90210



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INSURANCE & WORKERS' COMPENSATION ACCEPTED!
We accept most types of insurance providers and specialize in the treatment of workers' compensation injuries to the hand and upper extremity.





Carpal Tunnel Syndrome


Causes of Carpal Tunnel Syndrome (CTS)
Signs & Symptoms of CTS
Diagnosis & Medical History
Non-Surgical & Surgical Treatments

Carpal tunnel syndrome (CTS) is a wrist condition resulting from increased pressure on the median nerve at the wrist, much like if the nerve was pinched.

Carpal Tunnel Syndrome

Patients with CTS often experience symptoms such as numbness or tingling, and pain in the fingers, hand, or arm. Inside the wrist nine tendons pass from the wrist to the hand through a space called the carpal tunnel, and CTS occurs when the tunnel swells and pressure is put on the nerve. When the swelling and pressure gets large enough to affect the nerve's workings, then pain, numbness, or tingling may be felt in the hand and fingers.


Causes of Carpal Tunnel Syndrome (CTS)
The cause of carpal tunnel syndrome is frequently unknown because the pressure on the nerve can come from a variety of conditions. CTS can occur when the lining of the flexor tendons swell, a condition known as tenosynovitis. However, the tunnel can also be narrowed as a result of joint dislocations or fractures, or even from arthritis or keeping the wrist bent for long periods of time. The swelling and symptoms of CTS can also result from fluid retention during pregnancy although this condition usually passes shortly after giving birth. Carpal tunnel syndrome has also been linked with diabetes, some thyroid conditions, and rheumatoid arthritis, and a combination of causes is likely.

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Signs & Symptoms of CTS
The most common symptoms of carpal tunnel syndrome include pain, numbness, or tingling in the thumb, index, middle, and ring fingers. The symptoms, which may come in combination, are more pronounced at night. Additionally, symptoms are often noticed when performing routine daily activities (e.g., turning pages or driving).

Carpal Tunnel Surgery - Wrist Pain

A weaker grip or tendency to drop things is common, and occasional clumsiness may be a sign. If the syndrome advances to a severe case, sensation in the thumb or digits may be permanently lost, and the muscles of the thumb may slowly shrink in a condition called thenaratrophy. Thenaratrophy can cause difficulty with pinching.

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Diagnosis & Medical History
To correctly diagnose carpal tunnel syndrome, one of our hand surgeons will take a detailed medical history during your initial visit. This history will include any prior injuries as well as how the hands are, or have been, used. Arthritis or fractures may be checked with an x-ray, and laboratory tests may be used to check for the presence of other medical conditions associated with CTS. To confirm the diagnosis, a nerve conduction study or NCV may be performed along with an electromyogram or EMG. In addition to confirming CTS, these tests may identify other possible nerve conditions.

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Non-Surgical & Surgical Treatments
Many of our patients are relieved of the pain, numbness, and tingling associated with carpal tunnel syndrome without surgery.
Such symptoms are often treated by properly identifying and treating medical conditions, by changing habitual patterns of how the hands are used, or by keeping the wrist in a splint that will keep it straight, thereby reducing the pressure on the effected nerve. A wrist splint worn at night may lessen the symptoms that interfere with sleep, and an injection of steroids into the carpal tunnel may reduce the swelling around the nerve and help relieve the pain, numbness, or tingling.  
Treatment - Wrist Splint

If the symptoms are severe or don't respond to the above treatments, a physician then considers the possibility of carpal tunnel surgery or carpal tunnel release to make more room around the nerve. The surgery will trim the ligament on the top or palm side of the tunnel (fig 3) to relieve pressure on the nerve. While the location of the incision used for this surgery may vary, enlarging the tunnel and reducing pressure on the nerve is the desired result. After the surgery is performed, there may be soreness around the incision for several weeks or months, and several months may pass before wrist and hand strength returns to normal. In severe cases, the symptoms of carpal tunnel syndrome may not be entirely eliminated, not even following surgery.

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We serve the following cities within Los Angeles, which are in close proximity to our offices:
Agoura Hills, Brentwood, Canoga Park, Century City, Chatsworth, Culver City, Glendale, Granada Hills, Hollywood, Los Angeles, Marina Del Rey, North Hollywood, Northridge, Rancho Park, Reseda, Santa Monica, Sherman Oaks, Studio City, Tarzana, Valencia, Van Nuys, West Hills, West Hollywood, West L.A., Winnetka, Woodland Hills