Minimally Invasive Endoscopic Carpal Tunnel Release Surgery

If the condition is not treated, permanent deterioration of muscle tissue can occur.

Carpal Tunnel Syndrome (CTS) is one of the most commonly reported health problems. CTS occurs when swelling or pressure pinches the median nerve, the nerve that provides sensation to the palm side of the thumb, index, middle, and ring fingers. This is most commonly due to forceful or repetitive movement of the fingers and hand, especially when the wrist is in an awkward position. The best example of this is typing. The result can be a combination of tingling, numbness, weakness and pain in the fingers, thumb, palm, or forearm.


A nerve test is conducted to confirm the diagnosis. In CTS, the nerve fibers are being pinched; they will be deprived of blood flow and undergo irreversible changes and ultimately die unless the pressure is released before those irreversible changes take place.

The goal of treating CTS is not simply to reduce the pressure on the nerve so that the symptoms are tolerable and the patient can live with it. Rather, we seek to alleviate the pressure entirely. Waiting “until it gets too bad” is not advised, and one may actually end up with permanent nerve damage if they do put off treating their carpal tunnel syndrome.

Ineffective CTS treatments

  • Repetitive motion. Repetitive motion is often what causes CTS.  “Exercising away” the problem will only make it worse.
  • “Cold” lasers. There is no evidence to suggest that they actually decrease the flexor tenosynovium.
  • Splints Splints worn during the day decrease the muscle pumping action of the hand, cause more swelling in the hand, and increasing carpal tunnel symptoms.
  • Vitamin B-6 There is no scientific evidence to suggest that Vitamin B-6 helps treat CTS.
  • Topical creams. These often do not work because they cannot treat the root causes of CTS.
  • Magnets. There is no scientific evidence to suggest that magnets can help treat CTS.
  • Dietary supplements. There is no scientific evidence to suggest that magnets can help treat CTS.
  • Steroid injections. These are only temporary solutions and can cause permanent injury to the nerve if the needle is accidentally placed in the nerve, which usually happens on the third or fourth injection.
  • Open Carpal Tunnel Release Procedure. These can be effective, but they can also lead to weeks or months of pain and inability to work.

Endoscopic Carpal Tunnel Release Surgery (ECTR)

Supported by more than 20 years of peer review studies and by continuous improvements in technique, the ECTR is proven to be just as safe and effective as open procedures, with additional patient benefits.


  • A small, thin incision at the base of the wrist
  • Short recovery time
  • Little to no pain with the help of sedatives
  • The immediate alleviation of pain and numbness
  • No rehabilitative therapy needed

Patients are seen by appointment only. We participate in many insurance plans, including Worker’s Compensation. To determine whether we are a provider in your plan, please contact the plan directly, or the Office Manager at the Hand Center of San Francisco. Arrangements for Out-of-Network care can be made on an individual basis. Patients requiring prior authorization from their insurance plan for specialty care are responsible for obtaining and verifying authorization prior to their scheduled appointment.