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Carpal Tunnel Syndrome:
What is it and Treatment Options

What Is Carpal Tunnel Syndrome?

The carpal tunnel, a narrow passage in the wrist, houses the median nerve and the tendons responsible for finger flexion. Swelling in this area can compress the nerve, leading to pain and potential damage. If left untreated, carpal tunnel syndrome can result in:

  • Permanent weakness, numbness, and tingling.
  • Clumsiness when gripping objects
  • Numbness or tingling in the thumb and adjacent fingers
  • Palm numbness or tingling
  • Pain extending to the elbow, wrist or hand pain
  • Coordination issues with fine finger movements
  • Muscle wasting under the thumb in advanced cases
  • Weak grip or difficulty carrying bags, and weakness in one or both hands.


Our healthcare providers at Bluegrass Orthopaedics will conduct a thorough physical examination. This examination will involve:

  • Assessing grip strength
  • Tapping over the median nerve to check for pain (Tinel sign)
  • Inquiring about any numbness in specific areas of the hand
  • Phalen test, which involves bending the wrist forward for 60 seconds to assess for numbness, tingling, or weakness.
  • Tests such as X-Rays or EMG

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In-Office Procedures

We offer in-office procedures for various surgeries, which significantly reduces the cost for our patients compared to traditional methods. Our aim is to enhance the quality of care while minimizing the financial burden on our patients, ultimately providing greater value to those who are most important to us.


  • No general anesthesia = no nausea or vomiting
  • Much less cost to our patients
  • As safe as formal operating room
  • Equivalent or even better outcomes
  • No need for a driver
  • You can eat and drink like normal
  • If you have health problems you can avoid anesthesia
  • You get to talk and ask questions during the procedure, leading to better communication & more time with the surgeon

We have worked diligently to set this up because we believe it is better for you, the patient.

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Surgical Options

Surgery has proven to be an effective treatment for carpal tunnel syndrome when conservative treatment methods aren't achieving the desired result. As part of the surgery, the tissues of the ligament will gradually grow back together while allowing more room for the median nerve. Let's look at the three main types of carpal tunnel syndrome surgery offered at Bluegrass Orthopaedics.

Open Carpal Tunnel Release Surgery

With open carpaltunnel release surgery, a surgeon cuts the transverse carpal ligament toalleviate the pressure on the median nerve and relieve carpal tunnel syndrome  symptoms.

A small incision ismade at the base of the palm to provide visibility of the transverse carpalligament. Once the ligament is cut, the incision is closed using stitches. Thegap left by the cut ligament naturally fills with scar tissue over time. 

Open carpal tunnelrelease surgery is typically performed on an outpatient basis, allowingpatients to return home on the same day. The procedure is commonly done underlocal anesthesia, eliminating the need for a hospital stay.

Endoscopic Carpal Tunnel Release Surgery

This procedureinvolves the use of an endoscope, a thin tube equipped with a camera, which isinserted through a small incision in either the wrist (single-portal technique)or both the wrist and palm (two-portal technique). This allows doctors to visualize and access the structures within the wrist,such as the transverse carpal ligament, without the need for a large incision.

The cutting tools are incredibly small and areinserted through the same small incisions made in the wrist or wrist and palm. 

Byperforming endoscopic carpal tunnel release surgery, Bluegrass Orthopaedicseffectively cuts the transverse carpal ligament, thereby alleviating pressureon the median nerve. As a result, the symptoms associated with carpal tunnelsyndrome are relieved.

Ultrasound guidance and UltraGuideCTRâ„¢

The use of Ultrasound guidance and UltraGuideCTRâ„¢, is a procedure that uses ultrasound guidance to provide fast relief with minimized recovery time. The ultrasound delivers highly accurate imaging of the wrist anatomy for advanced precision and efficiency. This procedure allows for patients to realize immediate motion and get back to their daily activities sooner.

Some of the Main Benefits Include: 

- Most of our patients can return to work and otheractivities within 3 to 6 days.
- We offer convenient in-office treatment and same-dayrecovery.
- Minimized wrist incision, leaving minimal scarring without requiring sutures.
- Postoperative pain management only requiresover-the-counter medications.


Victor Marwin, MD, MBA
Physician Profile

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Patient Testimonial:  Minimally Invasive
Carpal Tunnel Surgery

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Patient Testimonial:  Minimally Invasive
Carpal Tunnel Surgery

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Patient Testimonial:  Minimally Invasive
Carpal Tunnel Surgery

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Victor Marwin, MD 
Carpal Tunnel Syndrome | WKYT's Everyday Kentucky

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