Understanding Carpal Tunnel Syndrome
Carpal tunnel syndrome occurs when the median nerve—one of the main nerves in the hand—becomes compressed as it passes through the narrow carpal tunnel at the wrist. This pressure can cause tingling, numbness, or pain in the thumb, index, and middle fingers. Over time, it may lead to muscle weakness or difficulty with tasks that require grip strength.
If you're experiencing these symptoms, Dr. Iyengar provides expert diagnosis and surgical care to relieve nerve compression and help you regain function — all right here in Puyallup. Early symptoms often include discomfort at night or while using the hands for repetitive tasks. Left untreated, the condition can interfere with daily activities and lead to permanent nerve damage.
When should I consider treatment?
While some patients find relief through splinting, rest, or physical therapy, surgery may be recommended when symptoms persist or worsen. If you're experiencing frequent hand numbness, difficulty gripping objects, or pain that disrupts sleep or daily life, it may be time to explore surgical options. Dr. Iyengar will perform a thorough evaluation to determine the best course of treatment for your needs.
What are my treatment options?
Standard Carpal Tunnel Release
This traditional surgical method involves making a small incision in the palm to access the carpal ligament. The ligament is then carefully divided to relieve pressure on the median nerve. As the ligament heals, the tunnel becomes wider, reducing compression and allowing symptoms to improve.
This technique is highly effective and has been used for decades to restore comfort and hand function.
Endoscopic Carpal Tunnel Release
For eligible patients, a minimally invasive approach may be recommended. Endoscopic carpal tunnel release involves a smaller incision—typically at the wrist or palm—and uses an endoscope (a thin tube with a camera) to visualize the ligament. Dr. Iyengar then releases the ligament with precision, minimizing disruption to surrounding tissues.
This approach often results in less post-operative discomfort, a quicker return to normal activities, and smaller scars.
Why choose Dr. Iyengar for this procedure?
Dr. Iyengar completed a fellowship training in hand and upper extremity surgery, equipping him with highly specialized knowledge in diagnosing and treating nerve compression disorders like carpal tunnel syndrome. His experience allows him to offer both traditional and minimally invasive techniques tailored to each patient’s unique needs.
Whether you need relief from long-term discomfort or are looking to restore your hand function, you’ll be in the hands of a surgeon who’s trained specifically for these types of procedures.
What does recovery look like?
Most patients experience a noticeable improvement in symptoms shortly after surgery, especially with nighttime pain and numbness. Light activities can typically be resumed within a few days, with full recovery over several weeks. In some cases, physical therapy may be recommended to support hand strength and flexibility during healing.
Check out how our patients looked before and after.
Check out galleryCheck out what our patients have to say.
Aimee S.
There isn't a bad thing I can say about Dr. Iyengar or my experience. I found Dr. Iyengar after I had been to a friend's consultation up in Bellevue. I heard her quote and options, and knew I wanted to be closer to home for my procedure. I got in for my consultation the same week as I had inquired about my procedure. Dr. Iyengar won me over with the fact that we both grew up in Puyallup, we share a love for Olive Garden breadsticks, he is friendly, knowledgeable, has an incredible bedside manner, taking time to answer questions and get to know your needs, professional, and funny. From consultation to 3 weeks post op, and everything in between has been an experience that I would recommend to family and friends, and have recommend to anyone that asks. If you're going back and forth, do yourself a favor and stop looking. Dr. Iyengar is your guy!! My BFF and I are proof that this guy is THE. BEST.
Lawrence W.
I was having trouble getting a grip on some hand tools, and at a restaurant that used round table ware rather than flat and edged utensils I notice I couldn't seem to hold them from rolling. My primary physician referred me to Dr. Iyengar. Probably one of the better 20 mile appointments I've had.Dupuytren's contracture, is the culprit the good doctor diagnosed and showed how it prevents my hand from lying flat on a table top because the little, and ring finger were closing on the palm. I mentioned that the middle finger of that hand also locked often with some pain associated with the nuisance. "We can take care of these two procedures today if you'd like" he offered and it made sense if he was willing, I'd travelled 20 miles for the diagnosis, getting the cure at the same time was more than just good sense.
In less than an hour, a pain free hour, the troublesome contracting cord had been freed up and a needle shot of a drug, perhaps cortisone, though I've forgotten, and I was on my way to the physical therapist to learn what I could do following up on the minimal surgery.
From the time I entered the office until I left was a pleasant and friendly exchange of information and personal stories. I didn't wait long, so short I could not get through reading the diplomas and advanced training and education certificates hanging on the walls that Dr. Iyengar has garnered from his studies and surgical skills.
The good doctor keeps a friendly atmosphere for staff and patients, for me 20 miles no longer seemed inconvenient. I'll see him for the followup and look forward to that. You'll be in good hands with Dr. Iyengar and staff.
Lisa R.
I have lived my entire adult life self conscious of my neck sagging and double chin. Dr. Iyengar took such good care and gave me a tight neck and for once in my life I have a jawline! I had a neck and lower face lift with lipo in my chin.
Liza C.
From my very first consultation, I was blown away by the level of care and professionalism at this practice. Every single team member, from the front desk to the medical coordinators and assistants, was friendly, attentive, and truly made me feel at ease. The customer service is top-notch!
Dr. Iyengar is exceptional. His experience, skill, and depth of knowledge shine through in every interaction. His bedside manner is warm and reassuring, and he takes the time to truly listen to your goals without ever being pushy. He’s incredibly responsive and makes you feel confident and cared for from day one. Honestly, his fresh perspective combined with his expertise is a major positive!
The aftercare has also been outstanding! Thorough, diligent, and consistently supportive. I’ve felt cared for every step of the way.
My entire experience has been nothing short of excellent. I’d highly recommend this practice to anyone looking for a team that’s professional, compassionate, and truly invested in your care. They set the bar high!
Jenny M.
I’m incredibly grateful that I was referred to Dr. Iyengar for my breast reconstruction surgery. From the very first consultation, he has been an absolute blessing throughout the entire process. His kindness, super friendliness (a rare trait), helpfulness, caring nature, and outstanding service are truly remarkable. Additionally, his extensive knowledge and confident responses to my questions, along with his ability to treat me with personable care, make him an exceptional surgeon.
Quality care in all realms of plastic and reconstructive surgery.
We see our patients as individuals, not just cases on the schedule. Dr. Iyengar makes every effort to get to know his patients personally and thoroughly understand their goals. This personalized approach ensures that every patient receives the highest quality care and achieves the results of their dreams! Dr. Iyengar executes every procedure with precision, integrity and utmost care.
Request a consultationGot questions about carpal tunnel treatment?
What’s the difference between open and endoscopic release?
How do I know if I have carpal tunnel syndrome?
Is surgery the only option?
How long is the recovery time?
Will the symptoms come back after surgery?
