The most common compression neuropathy — caused by pressure on the median nerve at the wrist. With timely treatment, the numbness, tingling, and night pain can be reversed.
Nerve compressed at the wrist
Typical release procedure
Back to light use
Carpal tunnel syndrome occurs when the median nerve is compressed as it passes through the carpal tunnel — a narrow passageway at the base of the palm formed by the wrist bones and a tough ligament. As pressure builds, the nerve can no longer send clear signals to the thumb, index, middle, and part of the ring finger.
Left untreated, that pressure progresses from intermittent tingling to constant numbness and, eventually, permanent weakness and muscle wasting at the base of the thumb. The encouraging news is that, caught early, carpal tunnel syndrome is one of the most treatable nerve conditions in surgery.
Fig: An entrapped nerve (left), surgical neurolysis releasing it (center), and the healthy decompressed nerve (right).
Diagnosis begins with a detailed history and a focused physical exam, including provocative tests that reproduce your symptoms. To confirm the diagnosis and grade its severity, Dr. Michaeli may order a nerve conduction study (NCS/EMG) and, when helpful, high-resolution ultrasound of the nerve.
Peripheral nerve surgery is its own discipline. Dr. Michaeli has dedicated his practice to the nerves, with fellowship-level training and thousands of nerve procedures.
Nerve work is measured in millimeters. Every repair is performed under high-magnification with microsurgical instruments and the latest reconstructive techniques.
Many patients arrive having been told nothing more can be done. A dedicated nerve evaluation often reveals options that general specialists do not offer.
Night splinting, activity modification, and targeted injections can relieve mild to moderate cases and are usually tried first.
A precise division of the transverse carpal ligament relieves pressure on the median nerve. Most releases take about 15 minutes.
When compression has been long-standing, additional microsurgical techniques can support nerve regeneration and recovery.
Many patients notice the night pain is gone the very first night. The hand is used for light activity right away.
The small incision heals; sutures are typically removed at around two weeks. Tingling continues to settle.
Grip strength rebuilds. Most patients return to normal work and activities within this window.
Sensation continues to improve. In long-standing cases, nerve recovery can continue for several months.
Peripheral Nerve & Brachial Plexus Surgeon · New Jersey & New York
Dr. Michaeli is among the most experienced and trusted peripheral nerve specialists on the East Coast, combining board-certified hand surgery expertise with dedicated peripheral nerve training. He has helped patients across the region regain function when they were told nothing more could be done.
What happens to the median nerve, when release surgery is the right choice, and what recovery feels like.
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“After years of being told my pain was something I’d have to live with, Dr. Michaeli found the nerve causing it and fixed it.”
Neuroma surgery
“I had given up hope of using my hand again. The nerve transfer gave me back movement the other doctors said was gone.”
Nerve transfer
“The carpal tunnel release was quick and the night pain was gone immediately. I only wish I’d done it sooner.”
Carpal tunnel release
A properly performed carpal tunnel release has a very high, durable success rate. Recurrence is uncommon. The key is addressing the compression before permanent nerve damage sets in.
Most patients drive within a few days and resume typing within one to two weeks, easing back as comfort allows.
Yes. When both wrists are affected, we plan treatment in a way that keeps you functional throughout — often staging the two procedures.
Schedule a consultation with Dr. Michaeli to understand your options and build a plan that fits your life.
