What is Carpal Tunnel Syndrome and its Symptoms

For excellent information on carpal tunnel syndrome, including pictures, causes, evaluation, and treatment, please see these websites.


Pub Med Health - Carpal Tunnel Syndrome

National Institute of Neurological Disorders and Stroke


Dr. Lett enjoys evaluating all neurological conditions but especially nerve problems in the extremities. In medical school, he wanted to do hand surgery but found that neurology was his true love in medicine. Dr. Lett was trained by the best Mayo Clinic neurologists who are still considered the best of the best, especially in evaluating peripheral nerve disorders. He remembers his first patient with carpal tunnel syndrome in 1976 when he was working with neurosurgeon Dr. Julius Goodman at Methodist Hospital. A patient had three prior cervical spine surgeries to cure his hand numbness when he presented to the neurosurgical clinic. An EMG/NCV testing confirmed that the patient actually had carpal tunnel syndrome rather than a pinched nerve in his neck. After he had carpal tunnel surgery, he was cured!


Dr. Lett has an over 30-year history of evaluating patients for possible carpal tunnel syndrome, and he spent 15 years in Indianapolis with Neurological Associates and then 13 years with The Indiana Hand Center as their neurologic disorder expert. He has performed thousands of evaluations on patients with suspected carpal tunnel syndrome. He is excited now to have opened the Center for EMG and Neurology and to begin the carpaltunnelindiana.com practice.


Dr. Lett loves the brain and hand connection, the hand being symbolic in being able to provide the physical communication for a person 's actions, touch, and expression of the brain. The best way to explain this is in the painting by Michelangelo in the Sistine Chapel. It portrays God giving life to man (Adam).


Sistine Chapel


If you look at God and his children in this picture, the area where God is residing is actually portrayed as the inside surface of the brain with the frontal lobe being by God's elbow and the pituitary stalk of the brain extending below. Thus, the brain and the hand are intimately connected in our being able to be alive and functioning human beings. Each half of the brain has a large representation controlling the hand sensation and motor skills.


With the hand, we give and receive love, we communicate, and we feel with the fingers and are able to manipulate our world.


In considering all of the possibilities for a patient's symptoms, Dr. Lett functions as an expert diagnostician to decipher the various possible conditions causing the patient's problem. Many people have carpal tunnel syndrome, but they also have additional conditions that contribute or compound the carpal tunnel syndrome. Dr. Lett can evaluate and treat all of these possible conditions.


Evaluation for carpal tunnel syndrome consists of Dr. Lett taking a face-to-face history of the problem, performing a physical examination and neurologic examination, and often performing an EMG/NCV testing. The EMG/NCV test has long been the gold standard for the diagnosis of carpal tunnel syndrome and also for the exclusion of carpal tunnel syndrome as a diagnosis. Dr. Lett is amazed on a daily basis of how many patients with carpal tunnel symptomatology simply do not have carpal tunnel syndrome (thus avoiding unnecessary treatment) or are proven to have other causes for their symptomatology. The clinical evaluation alone for carpal tunnel syndrome is not sufficient, and EMG/NCV testing validates or invalidates the diagnosis.


For excellent information on carpal tunnel syndrome, including pictures, causes, evaluation, and treatment, please see these websites.


Dr. Lett does not do any carpal tunnel surgery, so he has no vested interest in doing unnecessary surgeries, but if a carpal tunnel syndrome is clinically severe enough or severe on EMG/NCV testing, Dr. Lett knows the physicians and surgeons in central Indiana that could be used for surgical opinion. The goal is to improve the patient's symptomatology without surgery if possible.