Carpal tunnel syndrome is a common cause of hand pain, numbness, and weakness that is caused by a ligament in the wrist pressing on the median nerve, which supplies sensation and strength to parts of the hand.
Often times, a specific cause is not known, however, overuse (such as tying on a computer), thyroid disease, diabetes, and pregnancy can cause ligament pain, press on the nerve, and cause symptoms. Most cases of carpal tunnel syndrome present with pain such as numbness or weakness in the hands. This pain is most present at night due to way most of us sleep with our hands and wrists curled into our chests.
Often, treatment of the underlying disease can improve symptoms. This could include treatment of a thyroid, wearing a brace to prevent bending of the wrist, or after giving birth, pregnancy related symptoms may resolve. However, if treating the underlying disease does not improve symptoms, carpal tunnel release surgery is an outpatient procedure with good results.
There are two techniques for carpal tunnel release including open and endoscopic. Open surgery is done by cutting the ligament that presses on the nerve which causes pressure in the median nerve to be relieved. A disadvantage to this technique is scar formation and this can lead to reoperation. Endoscopic surgery is done similarly, but provides a smaller scar. However a potential disadvantage to this technique is that the limited incision may lead to incomplete cutting of the ligament and greater risk of nerve injury which could also lead to reoperation.
The two techniques have been debated on which is better, but both have their advantages and disadvantages meanwhile there appears to be no difference in long-term pain or strength/sensory improvement between open and endoscopic technique, so choosing between one or another is a personal preference.