Carpal Tunnel Release in Portland, OR
Samuel V. Bartholomew

Carpal Tunnel Release in Portland, OR

Carpal tunnel syndrome is the most common nerve compression problem in the hand. It causes numbness, tingling, and weakness in the thumb, index, and middle fingers, and it often wakes people up at night. When splinting and other conservative care stop working, carpal tunnel release surgery relieves pressure on the nerve to stop symptoms from progressing. Dr. Sam Bartholomew, MD, FACS performs carpal tunnel release as an outpatient procedure for patients at his Northeast Portland and Clackamas offices.

What Is Carpal Tunnel Syndrome?

The carpal tunnel is a narrow passageway at the base of your palm, formed by the wrist bones and a tough band of tissue called the transverse carpal ligament. The median nerve and nine tendons pass through it. When the tissues inside the tunnel swell or the space narrows, the median nerve is squeezed, which produces the classic symptoms of carpal tunnel syndrome.

Common contributing factors include:

• Repetitive gripping, typing, or use of vibrating tools
• Pregnancy and fluid retention
• Diabetes, thyroid conditions, and rheumatoid arthritis
• Wrist fractures or other injuries
• Family history and natural wrist anatomy

Symptoms

• Numbness or tingling in the thumb, index, middle, and part of the ring finger
• Symptoms that wake you up at night or flare while driving, reading, or holding a phone
• Shaking or flicking your hand to "wake it up"
• Weak grip, clumsiness, or dropping objects
• In advanced cases, constant numbness and visible wasting of the muscles at the base of the thumb

When Is Carpal Tunnel Surgery Recommended?

Mild carpal tunnel syndrome often improves with nighttime wrist splints, activity changes, and sometimes a steroid injection. Surgery is usually recommended when:

• Symptoms continue despite several weeks to months of conservative treatment
• Numbness is constant rather than occasional
• Nerve testing shows moderate to severe compression
• You notice weakness or muscle loss at the base of the thumb

Waiting too long can lead to permanent nerve damage, so it's worth an evaluation if your symptoms are getting worse.

The Carpal Tunnel Release Procedure

During your consultation, Dr. Bartholomew will examine your hand, review your symptoms, and may order a nerve conduction study to confirm the diagnosis and measure how severe the compression is.

Carpal tunnel release is an outpatient procedure, and you go home the same day. Depending on your needs, it is performed under local anesthesia with sedation or general anesthesia. Dr. Bartholomew:

• Makes a small incision at the base of the palm
• Divides the transverse carpal ligament to enlarge the tunnel and take pressure off the median nerve
• Closes the incision and applies a soft dressing

The ligament heals in a lengthened position, leaving more room for the nerve.

Recovery Timeline

• First 48 hours: Keep the dressing in place, elevate your hand above your heart, and ice for comfort.
• After 48 hours: You may remove the dressing and shower, then cover the incision with a bandage. A wrist splint is not needed after surgery.
• First week: Keep your hand elevated and move your fingers gently. Swelling, discomfort, and some numbness improve over this time.
• Weeks 1–6: Light daily activities and desk work can often resume early, but avoid lifting more than 2 pounds with the operated hand for at least 6 weeks. Some patients also attend hand therapy.
• After 6 weeks: Gradual return to gripping, lifting, and heavier work.

Tingling at night often improves quickly after surgery. Long-standing numbness and weakness can take several months to recover, and very severe cases may not recover completely. Read the full carpal tunnel release post-op instructions.

Is Carpal Tunnel Surgery Covered by Insurance?

Yes, in most cases. Carpal tunnel release is a medically necessary procedure, so it is generally covered by commercial health insurance, Medicare, and many Oregon Health Plan (OHP) plans when the diagnosis is documented. Coverage, referrals, and out-of-pocket costs depend on your plan. Our team will verify your benefits before surgery. Learn more about hand surgery insurance coverage in Portland.

Why Choose Dr. Bartholomew for Carpal Tunnel Release?

Dr. Bartholomew is double board-certified by the American Board of Plastic Surgery and the American Board of Surgery and is a Fellow of the American College of Surgeons. Plastic surgery training includes extensive work with the nerves, tendons, and soft tissue of the hand, and he brings the same careful technique to hand surgery that he uses in reconstructive and cosmetic procedures. He also treats related hand conditions, including trigger finger, ganglion cysts, Dupuytren's contracture, and thumb arthritis. See all of our hand surgery services.