Carpal Tunnel Syndrome Hand Surgeon in Jackson, TN
I’m Keith Michael Nord, MD, a fellowship-trained orthopedic hand surgeon at Sports Orthopedics & Spine in Jackson, Tennessee. This page answers the questions I hear most from patients about carpal tunnel syndrome, including symptoms, diagnosis, non-surgical care, surgery options, and when it is time to see a hand specialist in Jackson, TN.
What Is Carpal Tunnel Syndrome?
Carpal tunnel syndrome is a condition where the median nerve is squeezed as it passes through a tight tunnel in the wrist. The carpal tunnel is a narrow space made of wrist bones and a strong band of tissue (the transverse carpal ligament). When pressure inside this tunnel increases, the median nerve becomes irritated, causing numbness, tingling, pain, and sometimes weakness in the hand.
If pressure on the nerve continues for too long, the nerve can be permanently damaged. That is why it is important to recognize symptoms early and treat them before they become severe.
Common Symptoms of Carpal Tunnel Syndrome
Carpal tunnel symptoms often start gradually and may come and go. Over time, they usually become more frequent and bothersome.
- Numbness or tingling in the thumb, index, middle, and part of the ring finger.
- Nighttime symptoms that wake you up with tingling or burning, often relieved by shaking your hand.
- Hand pain in the palm or fingers, sometimes radiating up into the forearm.
- Weak grip, feeling like you cannot hold onto objects as well as before.
- Dropping objects, especially small items like keys, phones, or utensils.
- Clumsiness with fine tasks, such as buttoning clothes or handling jewelry.
- Sensation of swelling in the fingers even when they do not look swollen.
- Constant numbness and weakness in more advanced cases, with fingers that feel “dead” or “wooden.”
Early on, symptoms are often intermittent and mainly at night or with certain activities. As the condition progresses, symptoms can occur during the day and may become constant if the nerve stays compressed. Symptoms that involve the small finger or primarily affect the elbow may be due to a different nerve problem, such as cubital tunnel syndrome at the elbow rather than carpal tunnel syndrome at the wrist.
Causes and Risk Factors
Why the Median Nerve Gets Pinched
The carpal tunnel has little extra space. The median nerve and the tendons that bend your fingers all pass through this narrow channel. Anything that makes the tunnel smaller or increases the volume inside it can raise pressure on the nerve and lead to carpal tunnel syndrome.
Common Causes and Risk Factors
- Repetitive hand and wrist use — Frequent gripping, pinching, or bending of the wrist (tools, assembly work, driving, keyboard and mouse use).
- Prolonged bent wrist positions — Working with the wrist flexed or extended for long periods increases pressure on the median nerve.
- Pregnancy — Fluid retention and hormonal changes can swell tissues in the tunnel. Symptoms often improve after pregnancy but sometimes persist.
- Medical conditions — Diabetes, thyroid disease, rheumatoid arthritis, and other inflammatory or metabolic conditions increase the risk of nerve compression.
- Prior wrist injury or arthritis — Fractures, dislocations, or arthritis can change the shape of the carpal tunnel. In some patients, a prior wrist fracture, post-traumatic arthritis, or thumb arthritis (CMC/basal joint arthritis) narrows the tunnel and contributes to nerve compression or overlapping hand pain.
- Genetics and anatomy — Some people naturally have a smaller carpal tunnel.
- Fluid retention — Conditions that cause generalized swelling can raise pressure in the tunnel.
- Work and hobbies — Vibrating tools, sewing, knitting, musical instruments, and sports involving gripping may contribute.
For many patients, there is no single cause. Carpal tunnel syndrome usually develops from a combination of anatomy, daily use, and underlying health conditions.
How Carpal Tunnel Syndrome Is Diagnosed
Diagnosis starts with a detailed discussion of your symptoms and a focused exam of your hands, wrists, and arms. In many cases, I can diagnose carpal tunnel syndrome based on your history and physical exam alone. Sometimes we add nerve testing to confirm the diagnosis or measure how severe it is.
History and Physical Examination
During your visit at Sports Orthopedics & Spine in Jackson, TN, we will review:
- Which fingers are affected and when symptoms occur.
- Your work, hobbies, and daily hand use.
- How long symptoms have been present and whether they are getting worse.
- Any neck, shoulder, or elbow problems that could be related, including symptoms of ulnar nerve compression at the elbow (cubital tunnel syndrome).
- Your medical history, including diabetes, thyroid issues, arthritis, or prior injuries.
I then examine your hands, wrists, and arms, checking sensation, strength, reflexes, and the pattern of numbness. This helps distinguish carpal tunnel syndrome from other causes of hand symptoms, such as pinched nerves in the neck or ulnar nerve compression at the elbow.
Special Office Tests
Two simple tests often support the diagnosis:
- Tinel’s sign: Tapping over the carpal tunnel at the wrist causes tingling or an “electric shock” feeling into the thumb, index, or middle fingers.
- Phalen’s test: Pressing the backs of your hands together with wrists bent for about a minute reproduces numbness or tingling in the median nerve fingers.
Nerve Conduction Studies and EMG
In some patients, I recommend nerve conduction studies (NCS) and electromyography (EMG). These tests measure how well the median nerve carries electrical signals and can:
- Confirm that symptoms are due to carpal tunnel syndrome.
- Show how severe the nerve compression is.
- Help rule out other nerve problems, such as pinched nerves in the neck or at the elbow.
Nerve testing is especially useful when symptoms are unusual, when we are worried about permanent nerve damage, or when we are planning surgery.
Non-Surgical Treatment Options
Many people with mild to moderate carpal tunnel syndrome improve without surgery, especially when symptoms are caught early. The main goals are to reduce pressure on the median nerve and control inflammation.
Wrist Splints
A neutral wrist splint keeps your wrist straight, the position with the lowest pressure in the carpal tunnel. Splints are usually worn at night and sometimes during activities that trigger symptoms.
Splinting works best when:
- Symptoms are mostly at night or with specific activities.
- Numbness is intermittent, not constant.
- There is little or no muscle wasting at the base of the thumb.
Activity Changes and Ergonomics
Small changes in how you use your hands can significantly reduce symptoms:
- Take frequent short breaks from repetitive or forceful hand tasks.
- Keep wrists in a neutral position while typing, driving, or using tools.
- Use larger-handled tools or ergonomic keyboards and mice.
- Avoid prolonged gripping, pinching, or vibrating tools when possible.
Medications
Over-the-counter anti-inflammatory medications (such as ibuprofen or naproxen) may help relieve pain for some patients, but they do not correct the underlying compression. They are usually used short-term and only if they are safe for your overall health. We will review your medical history before recommending medication.
Corticosteroid Injections
A corticosteroid injection placed into the carpal tunnel can reduce swelling around the tendons and relieve pressure on the median nerve. Many patients experience meaningful relief, sometimes for months or longer.
Injections tend to work best when:
- Symptoms are moderate and fairly recent.
- There is no significant muscle wasting at the base of the thumb.
- Numbness is not constant and severe.
Relief from injections can be temporary. If symptoms return or remain severe, surgery often provides the most reliable long-term solution.
Treating Underlying Conditions
Managing contributing conditions such as diabetes, thyroid problems, or inflammatory arthritis can help reduce overall nerve irritation and may improve your response to other treatments. Some patients also have other tendon and joint problems, such as De Quervain’s tenosynovitis at the thumb side of the wrist, trigger finger in the fingers, or thumb arthritis at the base of the thumb, which can be evaluated and treated at the same visit.
Surgical Treatment Options for Carpal Tunnel Syndrome
If non-surgical treatments do not provide enough relief, or if there is evidence of ongoing nerve damage, surgery is often the most effective and predictable treatment. All surgical options have the same goal: to permanently relieve pressure on the median nerve by releasing the tight ligament that forms the roof of the carpal tunnel.
Traditional Open Carpal Tunnel Release
In an open release, a small incision is made in the palm. Through this opening, the surgeon directly sees and cuts the transverse carpal ligament, creating more space for the median nerve. This approach has been used successfully for many years and remains a reliable option.
Recovery usually includes some soreness in the palm and a short period of limited heavy use while the incision heals.
Endoscopic Carpal Tunnel Release
Endoscopic carpal tunnel release uses a small camera and instruments inserted through a small incision in the wrist or palm. The ligament is cut from the inside under camera guidance. Some patients may regain grip strength slightly faster with this technique, but long-term results are similar to open surgery when either is done correctly.
Ultrasound-Guided Carpal Tunnel Release in Jackson, TN
At Sports Orthopedics & Spine in Jackson, TN, I offer ultrasound-guided carpal tunnel release, a minimally invasive technique performed in the office under local anesthesia. Live ultrasound allows me to see the median nerve, tendons, and ligament in real time while performing the release.
Key features of ultrasound-guided carpal tunnel release include:
- Office-based procedure — Performed in our office procedure room rather than a hospital or surgery center.
- Local anesthesia only — The wrist and palm are numbed; you remain awake. Most patients do not need general anesthesia.
- Very small incision — A tiny incision may lead to less soft-tissue disruption compared with traditional open surgery.
- Real-time ultrasound visualization — The median nerve and surrounding structures are seen throughout the procedure to guide a precise release.
- Quicker return to light activity — Many patients are able to resume light daily use of the hand quickly, although total recovery time still varies based on the individual and job demands.
- Potential cost savings — Because the procedure is done in the office under local anesthesia, overall costs are often lower than hospital- or surgery-center-based procedures.
Not everyone is a candidate for ultrasound-guided release. During your evaluation, we will review your symptoms, anatomy, medical history, and any nerve testing to decide which surgical option is safest and most appropriate for you.
Recovery and What to Expect
Recovery with Non-Surgical Care
With splinting, activity changes, and possibly injections, many patients notice improvement over several weeks. The timeline depends on how long the nerve has been compressed and how severe the symptoms are.
- First few weeks: Nighttime numbness often improves first, especially with consistent splint use.
- 4–8 weeks: Daytime symptoms may lessen, and hand function may feel more normal.
- After 2–3 months: If symptoms are not clearly improving, or if they worsen again, we will discuss whether surgery is the better long-term option.
Persistent or worsening numbness, weakness, or thumb muscle loss despite non-surgical treatment can be a sign that the nerve needs more definitive decompression.
Recovery After Carpal Tunnel Surgery
Once the ligament is released, pressure on the nerve is reduced right away, but nerves heal slowly. Symptom improvement usually happens over weeks to months, not overnight.
- First few days: Expect soreness at the incision and some swelling. Moving your fingers is encouraged to prevent stiffness.
- 1–2 weeks: Stitches (if present) are usually removed. Light hand use is generally allowed, but we limit heavy lifting, forceful gripping, and repetitive strain.
- 3–6 weeks: Many patients return to most daily activities and light work. Discomfort gradually decreases.
- 6–12 weeks: Grip strength, endurance, and fine motor control continue to improve. Some tenderness in the palm with pressure is common early on.
- Several months and beyond: Numbness and tingling can keep improving for up to a year, especially if symptoms were present for a long time before surgery.
Patients with long-standing, severe carpal tunnel syndrome may not fully regain normal feeling or strength, even after successful surgery. This is why timely evaluation and treatment are important.
When to See a Hand Surgeon in Jackson, TN
You do not need to wait until symptoms are severe to see a hand specialist. Earlier evaluation often means more options and a better chance of full recovery. You should consider seeing a hand surgeon if:
- You have numbness, tingling, burning, or pain in the thumb, index, middle, or ring fingers that keeps coming back.
- Symptoms wake you up at night or interfere with daily activities or work.
- You notice dropping objects, clumsiness, or difficulty with fine motor tasks.
- Numbness is becoming constant rather than occasional.
- You see thinning of the muscles at the base of your thumb.
- Splints, activity changes, or injections have not provided lasting relief.
A fellowship-trained hand surgeon can confirm the diagnosis, judge how advanced the nerve compression is, and guide you through both non-surgical and surgical options that fit your goals and lifestyle.
Schedule a Carpal Tunnel Evaluation with Dr. Keith Michael Nord
If you live in or near Jackson, TN and are concerned about carpal tunnel syndrome, scheduling an evaluation is an important next step. At Sports Orthopedics & Spine, I will listen to your symptoms, examine your hands and wrists, review any prior tests, and explain your options in clear language. Together, we will decide whether continued conservative care, an injection, or surgery — including the option of ultrasound-guided carpal tunnel release — is right for you.
To schedule an appointment with me, Dr. Keith Michael Nord, fellowship-trained hand surgeon at Sports Orthopedics & Spine in Jackson, Tennessee, please request a carpal tunnel evaluation online. Early diagnosis and treatment can protect your hand function and help you return to daily activities with less pain and more confidence.
Frequently Asked Questions About Carpal Tunnel Syndrome
How do I know if I have carpal tunnel syndrome?
The most common signs of carpal tunnel syndrome are numbness, tingling, or burning in the thumb, index, middle, and part of the ring finger, especially at night or with activities that bend the wrist. You may find yourself shaking your hand to “wake it up,” dropping objects, or noticing weakness with gripping or pinching. Symptoms that mainly involve the small finger or start at the elbow may point to a different condition, such as cubital tunnel syndrome. A focused exam and, when needed, nerve testing can confirm the diagnosis.
Is carpal tunnel surgery painful?
Carpal tunnel surgery is typically done with local anesthesia, sometimes with light sedation. During the procedure, you should feel pressure but not sharp pain. After surgery, most patients describe soreness or aching in the palm and wrist for several days to a few weeks. Over-the-counter pain medicine and elevation are usually enough to control discomfort, though stronger medication can be used briefly if needed. Severe or long-lasting pain is uncommon, and we will review a pain-control plan with you before surgery.
How long is recovery from carpal tunnel surgery?
Most people can use their hand for light activities such as eating, dressing, and typing within a few days, depending on the type of work they do and the technique used. Many patients return to office work or light duty within 1–2 weeks, while heavy lifting, forceful gripping, or repetitive manual labor may need to be restricted for several more weeks. Numbness and tingling often improve quickly but can continue to recover for months, especially if symptoms were present for a long time before surgery.
Can carpal tunnel go away without surgery?
Mild carpal tunnel syndrome related to pregnancy, short-term overuse, or reversible medical issues may improve with rest, splinting, activity changes, and sometimes a corticosteroid injection. However, when numbness is constant, symptoms have been present for many months, or there is visible weakness or wasting of the thumb muscles, the nerve is at higher risk for permanent damage. In those situations, surgery is usually the most reliable way to relieve pressure on the nerve and protect long-term hand function.
What happens if carpal tunnel is left untreated?
If pressure on the median nerve continues, symptoms can progress from intermittent tingling to constant numbness, weakness, and loss of fine motor control. The muscles at the base of the thumb may shrink, and some of the damage to the nerve can become permanent. At that stage, even a technically successful surgery may not fully restore normal sensation or strength, which is why early evaluation is important when symptoms persist.
Can carpal tunnel come back after treatment?
Most patients have long-lasting relief after carpal tunnel surgery, but symptoms can rarely recur, especially if there is significant scarring, ongoing heavy hand use, or underlying medical conditions that affect nerves. Mild recurrences are sometimes managed with splinting, activity changes, or an injection. If symptoms become significant again, a repeat evaluation can determine whether additional treatment is needed.
What is carpal tunnel syndrome?
Carpal tunnel syndrome happens when the median nerve is squeezed as it passes through a narrow tunnel in the wrist. This pressure irritates the nerve and causes numbness, tingling, pain, and sometimes weakness in the hand and fingers. Over time, ongoing pressure can damage the nerve, so early diagnosis and treatment are important.
How do I know if I have carpal tunnel syndrome?
You may have carpal tunnel syndrome if you notice numbness, tingling, or burning in the thumb, index, middle, and part of the ring finger, especially at night or with activities that bend the wrist. Shaking your hand to “wake it up” is common. A focused exam, and sometimes nerve testing, can confirm the diagnosis.
Can carpal tunnel syndrome go away on its own?
Mild cases related to pregnancy, temporary overuse, or short-term swelling may improve with rest, night splints, and activity changes. When symptoms are frequent, long-standing, or include constant numbness or weakness, they are unlikely to resolve on their own. In those situations, we talk about more definitive treatment to protect the nerve.
Will I need surgery for carpal tunnel syndrome?
Not everyone needs surgery. Many patients with mild to moderate symptoms improve with splints, activity changes, and sometimes a corticosteroid injection. I usually recommend surgery when symptoms are severe, have lasted many months, or when nerve testing shows ongoing damage. We will review your options together based on your exam and goals.
How long is recovery after carpal tunnel release surgery?
Most people use their hand for light activities within a few days and return to office work or light duty in about 1–2 weeks. Heavier work, forceful gripping, and repetitive tasks may be limited for several more weeks. Nerves heal slowly, so numbness and tingling can keep improving for several months.
Is carpal tunnel surgery covered by insurance?
Most health insurance plans cover carpal tunnel evaluation and surgery when it is medically necessary. Coverage details, copays, and deductibles vary by plan. Our office team can help you confirm your benefits and obtain any needed authorizations before scheduling your procedure.
Sports Orthopedics and Spine 