Donya Currie is the editor of The Free Lance-Star's Healthy Life section and Healthy Life Virginia newsletter.

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More on carpal tunnel

After reading a story on carpal tunnel syndrome in Healthy Living on Sunday, a local hand surgeon emailed writer Katie Thisdell, wanting to elaborate on surgical options for treating the condition.

Dr. Mike O’Brien, an orthopedic surgeon at Central Virginia Orthopaedics & Sports Medicine in Fredericksburg, has done carpal tunnel surgeries for more than 30 years. Here’s what he said about the three surgery choices our story briefly touched on—open release, endoscopic and MANOS incisionless. 


“The public should know what they’re getting and at what cost. All 3 procedures require that the patient changes their clothes, waits for the doctor, and if a general or axillary block anesthesia is used, then a lot more time while an IV is started and the anesthesia is started, etc. The real numbers are the key and they are universal: surgical time (start to finish of the operation itself) is less than 10 minutes for an “open” procedure — [which involves] a 2-3 inch incision, essentially no complications, near perfect outcomes, and a nominal cost.

The “endoscopic” (arthroscopic) is 15-20 minutes usually, if done by an experienced doctor. [It involves] some increased complications (hurting the nerve), usually excellent outcomes, BUT at least 5x’s the cost (which we, as the public, ultimately pay for-always!). The MANOS [procedure] is new, takes 10-15 minutes in experienced hands, much higher risk of nerve and artery injury and also 3-5x’s more expensive.

These latest 2 procedures were invented to “speed” recovery. In a tiny percentage of patients, they may help, but over 90% of patients do fine with the standard procedure and go back to work within a week.”

Thanks to Dr. O’Brien for sharing his insights, and to the patients and Dr. Kostas Constantine, another local orthopedic surgeon, and Dr. Christine Thompson, a chiropractor, who shared their wisdom and experiences for our story. And thanks to Katie, who wrote the original story, for passing along Dr. O’Brien’s information for this blog post.

To read Sunday’s story, click here: