Carpal Thenar Disorder Case Studies

DOI: 5/6/2016. Patient is a 53-year-old right hand dominant female welder who sustained injury due to welding for the last 8-9 years. Per OMNI, he was initially diagnosed with carpal tunnel syndrome.
Per the medical report dated 05/17/16, the patient reported bilateral hand pain with numbness and tingling for the past 7 years or so, worsening, right greater than the left side. There is some degree of numbness/tingling on the right hand at all times. She has difficulty sleeping at night due to pain and driving, doing her hair/make up or holding objects worsen her symptoms. She has tried wearing splints that they worsened the discomfort. She denies any history of steroid injections. On examination, Tinel’s, Durkan’s and Phalen’s tests are positive bilaterally. There is bilateral thenar weakness.

She is unable to wear the splint at night because they worsen the pain. She also reports some pain in the posterior aspect of the left elbow, she thinks from chronic contact of this area on a table surface or something similar at work.
On examination, there is mild tenderness at the posterior olecranon of the left elbow. Of note, EMG/nerve conduction studies dated 05/25/16 showed a “severe right sensory motor median neuropathy across the carpal tunnel. There is a moderate left sensory motor median neuropathy across the carpal tunnel. There is a mild left ulnar neuropathy across the cubital tunnel.“ Impression includes severe right carpal tunnel syndrome, moderate left carpal tunnel syndrome, mild left ulnar neuropathy across the cubital tunnel and early mild olecranon bursitis of the left elbow. She would like to move forward with right carpal tunnel release.
Current request is for 1 Right Carpal Tunnel Release between 7/12/2016 and