Carpal Tunnel Surgery in NYC
5,000+ successful procedures by Castle Connolly Top Doctors. Endoscopic technique with generally faster recovery, less pain, and superior outcomes. Same-week appointments available.
Carpal Tunnel at HSSI
What Is Carpal Tunnel Syndrome?
Carpal tunnel syndrome (CTS) is the most common nerve compression disorder of the upper extremity, affecting an estimated 3–6% of adults. It occurs when the median nerve—which runs from your forearm through a narrow passage in your wrist called the carpal tunnel—becomes compressed or squeezed.
The carpal tunnel is formed by the wrist bones (carpals) on three sides and the transverse carpal ligament on the palm side. This tunnel contains nine flexor tendons and the median nerve. When the tunnel narrows or the contents swell, pressure builds on the median nerve, causing characteristic symptoms.
The median nerve controls sensation to the thumb, index finger, middle finger, and half of the ring finger. It also controls some small muscles at the base of the thumb. When compressed, patients experience numbness, tingling, weakness, and pain that can significantly impact daily activities and work.
Carpal Tunnel Symptoms
Symptoms typically develop gradually and may come and go at first. Early recognition is important—the condition is easier to treat before permanent nerve damage occurs.
Early Symptoms
Numbness and tingling — “Pins and needles” in the thumb, index, middle, and ring fingers. May wake you at night or occur when holding a phone or steering wheel.
Hand weakness — Difficulty gripping objects, tendency to drop things, trouble with buttons or zippers.
Pain and discomfort — Aching in the hand, wrist, or forearm. Pain may radiate up the arm toward the shoulder.
Progressive Symptoms
Constant numbness — Tingling that no longer comes and goes but is present most or all of the time.
Muscle wasting (thenar atrophy) — The muscles at the base of the thumb may shrink and weaken.
Loss of fine motor control — Difficulty with writing, buttoning clothes, or picking up small objects.
How Is Carpal Tunnel Diagnosed?
Accurate diagnosis is essential because other conditions—cervical radiculopathy, thoracic outlet syndrome, pronator syndrome, and peripheral neuropathy—can mimic carpal tunnel symptoms. At HandSport Surgery Institute, our surgeons perform a comprehensive evaluation:
Clinical Examination
- Symptom history: Location, timing, aggravating factors, and how symptoms affect work and daily activities
- Physical examination: Testing sensation, strength, and muscle bulk. Provocative tests like Phalen’s maneuver, Tinel’s sign, and Durken’s test
- Kinetic chain assessment: Evaluating neck, shoulder, elbow, and wrist to identify contributing factors and rule out other conditions
Diagnostic Studies
- Nerve conduction studies (NCS) and EMG: Measure how well the median nerve transmits signals. Confirm diagnosis, assess severity, rule out other problems
- Imaging: X-rays to evaluate wrist bones. Ultrasound or MRI to visualize the median nerve when diagnosis is unclear
Non-Surgical Carpal Tunnel Treatment
Drs. Pruzansky emphasize non-operative treatments whenever possible. For mild to moderate carpal tunnel syndrome, conservative measures often provide significant relief.
Wrist Splinting
A neutral-position wrist splint worn at night prevents the wrist from flexing during sleep—a common cause of nighttime symptoms. Custom splints can be fabricated by occupational therapists.
Activity Modification
Identifying and modifying positions and motions that worsen symptoms. Ergonomic adjustments to your workstation, frequent breaks, and changing hand positions during activities.
Physical & Occupational Therapy
Hand therapy may improve symptoms through nerve gliding exercises, tendon stretching, and strengthening. Therapists provide ergonomic education and activity modification strategies.
Types of Carpal Tunnel Surgery
Carpal tunnel release surgery divides the transverse carpal ligament, enlarging the carpal tunnel and relieving pressure on the median nerve.
Endoscopic Carpal Tunnel Release (Our Preferred Technique)
Uses a small camera and specialized instruments inserted through one or two small incisions (typically half an inch or less). The surgeon views the transverse carpal ligament on a monitor and cuts it from inside the tunnel, enlarging the tunnel and reducing pressure on the median nerve.
Advantages:
- Smaller incisions: One or two quarter-inch incisions vs. a two-inch palmar incision
- Faster recovery: Most patients return to desk work within 1–2 weeks
- Less post-operative pain: Reduced tissue trauma means less discomfort
- Superior grip strength recovery: Studies show faster return of grip and pinch strength
- Outpatient procedure: Takes approximately 10 minutes; you go home the same day
Dr. Mark Pruzansky and Dr. Jason Pruzansky have performed over 5,000 endoscopic carpal tunnel releases—one of the highest volumes in the New York region.
Traditional Open Release
Uses a longer incision (approximately 2 inches) extending from the wrist into the palm and requires a longer recovery period.
When used: Open release may be indicated for complex cases, revision surgery, or when combined with other procedures such as tendon repair, tumor removal, or wrist fracture re-alignment.
Which Technique Is Best?
For most patients, endoscopic release offers the best combination of outcomes—faster recovery, less pain, and equivalent long-term results. Our surgeons evaluate each patient individually and recommend the approach most likely to produce the best outcome.
What to Expect: Carpal Tunnel Surgery at HSSI
Consultation and Evaluation
Your first visit includes a thorough examination by Dr. Mark or Dr. Jason Pruzansky—not a physician assistant. We review your symptoms, examine your hand and upper extremity, and discuss diagnostic studies if needed. You’ll receive a clear explanation of your condition and all treatment options. Most consultations last 30–45 minutes.
Pre-Operative Planning
If surgery is recommended, we explain the procedure in detail, answer your questions, and coordinate scheduling. Our staff assists in insurance verification and prior authorization. You’ll receive written pre-operative instructions including medication adjustments.
Surgery Day
Almost all outpatient surgeries are performed at Surgicare of Manhattan and Manhattan Eye, Ear and Throat Hospital (part of Lenox Hill Hospital). The procedure typically takes about 10 minutes. Most patients receive local anesthesia with sedation—you’re relaxed but awake. After surgery, your hand is wrapped in a light dressing and you go home within an hour.
Recovery
First few days: keep hand elevated, move fingers to prevent stiffness. 1 week: light dressing removed, most patients can do light activities and desk work. 1–2 weeks: sutures removed, gradually resume normal activities. 4–6 weeks: recovery from surgery for most patients. 3+ months: maximum improvement in nerve function.
Follow-Up Care
Dr. Pruzansky personally supervises your recovery with scheduled follow-up visits. If hand therapy is recommended, we coordinate with certified occupational therapists and guide your rehabilitation program.
Carpal Tunnel Surgery Recovery: Detailed Timeline
Endoscopic Release Recovery
Factors Affecting Recovery
- Age: Younger patients typically recover faster
- Pre-operative severity: Mild compression recovers faster than severe, longstanding damage
- Overall health: Diabetes, thyroid disorders can slow nerve healing
- Occupation: Desk workers return to work faster than laborers
- Compliance: Following instructions and attending therapy optimizes recovery
Carpal Tunnel Surgery Cost and Insurance
Insurance We Accept
- Aetna
- Blue Cross Blue Shield
- Cigna
- United Healthcare
- Medicare
- Oxford, Empire, Emblem Health
- Many other commercial plans
Our staff assists in verifying coverage before your appointment and handles prior authorization. We’ll explain expected out-of-pocket costs before scheduling surgery.
What Determines the Cost?
- Surgeon’s fee: The professional fee for performing the surgery
- Facility fee: Charges from the hospital or surgery center
- Anesthesia fee: Charges for anesthesia services
- Pre- and post-operative care: Consultations, imaging, and follow-up visits beyond 3 months
For patients without insurance or with high-deductible plans, we offer transparent self-pay pricing and options. Contact our office at 212-249-8700 to discuss payment concerns. If we are out-of-network for your insurance, our staff will help you understand your out-of-network benefits.
Why Choose HandSport Surgery Institute for Carpal Tunnel Surgery?
Unmatched Volume and Experience
Over 5,000 carpal tunnel procedures performed. Research consistently shows higher-volume surgeons achieve better outcomes with fewer complications.
Endoscopic Specialists
Not every surgeon offers endoscopic carpal tunnel release—it requires specialized training and equipment. Our surgeons have performed thousands of endoscopic releases.
Accurate Diagnosis
Our kinetic-chain approach evaluates the entire upper extremity. We don’t just treat carpal tunnel—we make sure that’s actually what you have.
Personal, Unhurried Care
Dr. Pruzansky personally sees every patient, performs every procedure, and conducts every follow-up. Consultations last 30–45 minutes.
Convenient Manhattan Location
Park Avenue office with on-site digital X-ray. Easily accessible from throughout Manhattan and the tri-state area.
Castle Connolly Top Doctors
Both surgeons named Castle Connolly Top Doctors. Dr. Mark Pruzansky ranks in the top 1.4% nationally with triple board certification.
What Our Carpal Tunnel Patients Say
"I had carpal tunnel surgery with Dr. Pruzansky and could not be happier with the results. The procedure was quick, recovery was faster than expected, and my hand feels better than it has in years."
"After years of waking up with numb hands, I finally had the surgery. Dr. Pruzansky explained everything clearly, and the endoscopic technique meant I was back at work in a week. Wish I had done it sooner."
"Dr. Pruzansky is the best doctor/orthopedist I’ve ever been to. He fixes issues that other doctors don’t even know how to diagnose and is with you every step of the way."
"Very professional and helpful office. Dr. Pruzansky provided everything I needed for my procedure, followed up and is guiding me through all I can do to heal quickly and effectively."