Rachael Thomas worked for years in office jobs before tiring of it. So, in 2021, she opened a licensed commercial in-home bakery, Batter-Up Bakery, in Williamsport, Pa.
The business allowed Rachael to follow her passion. However, she was also dealing with increasing pain, numbness, and tingling in her right wrist due to carpal tunnel syndrome.
The symptoms eventually became so severe that they began to affect Rachael’s business and everyday life. So, she visited Fadi Sweiss, MD, board-certified neurosurgeon, UPMC Neurological Institute in North Central Pa. Dr. Sweiss performed a minimally invasive, ultrasound-guided carpal tunnel release procedure in summer 2023.
Two years after the procedure, Rachael no longer feels symptoms.
“(The procedure) literally saved my business,” says Rachael, 43, of Williamsport. “I think there would be a lot of unhappy people in the area if they couldn’t get my specialty cheesecakes anymore.”
Tingling and Pain
Carpal tunnel syndrome occurs when tendons in the wrist swell and put pressure on the nerve that travels to the hand. It causes symptoms like numbness, pain, and tingling.
Rachael first experienced minor tingling in her right wrist in 2018, when she was still working in an office setting.
“It was no big deal,” she says. “I didn’t really think a whole lot of it.”
However, when Rachael opened her bakery in 2021, the symptoms started to worsen. Making decorated sugar cookies was especially difficult because it required intricate work with her affected hand and wrist.
“It was to the point where in the mornings, I’d wake up, and I’d have to wait an hour until my hand came back to brush my teeth,” she says. “I couldn’t hold my phone, I couldn’t hold a toothbrush to brush my teeth. It was just really bad.”
Rachael started visiting a chiropractor for her symptoms, trying laser therapy and other nonsurgical treatments. She wore a brace on her wrist every night when she went to bed.
However, her symptoms continued to get worse. She sometimes woke up in the middle of the night with pain, and the numbness and pain caused her issues with everyday activities.
“It was annoying,” she says. “I have no patience. I couldn’t even sit and hold my phone and play a game on it for more than two minutes. Or text somebody!
“It was just a disruption all the time.”
Seeking Care
By spring 2023, Rachael announced on her business Facebook page that she had to stop making decorated sugar cookies until she found a solution for her carpal tunnel syndrome.
One of Rachael’s customers, who worked in Dr. Sweiss’ office, commented on Rachael’s Facebook post. The customer told Rachael about an ultrasound-guided procedure that Dr. Sweiss offered to treat carpal tunnel syndrome.
The ultrasound-guided carpal tunnel release is minimally invasive, doesn’t require general anesthesia, and takes only minutes to complete. Patients also have shorter recovery times.
The idea of a minimally invasive procedure was attractive to Rachael, who says she doesn’t do well with general anesthesia. But she continued to consider all of her options, including surgery.
By the time July rolled around, Rachael decided to contact Dr. Sweiss’s office about the ultrasound-guided procedure.
“It just kept getting worse, even with going to the chiropractor and doing the laser,” Rachael says. “So, finally, I called, and they happened to be doing a free carpal tunnel screening that week.”
Rachael visited the UPMC Neurological Institute at UPMC Williamsport for the consultation.
“Dr. Sweiss was very kind and encouraging, soft-spoken, and just explained everything very well,” she says.
He took imaging to check the severity of Rachael’s carpal tunnel and asked her when she’d like to schedule her procedure.
“I said, ‘Honestly, this would be the best time of year. This is my slowest time for the bakery,’” she says.
Rachael spoke to Dr. Sweiss’ staff and scheduled an appointment for the following week.
A Successful Procedure
During the procedure, Dr. Sweiss made a small incision in Rachael’s wrist area. Using an ultrasound for guidance, he inserted a small handheld tool with a microblade into the incision and cut the carpal ligament.
Unlike an open carpal tunnel release, the procedure requires only a local anesthetic and a very small incision that is closed with a Steri-Strip, rather than traditional stitches or sutures.
“There is no need for patients to go to the (operating room), and patients do not need general anesthesia, conscious sedation, or nerve blocks,” Dr. Sweiss says. “Due to the minimally invasive approach, there is no need to hold blood-thinning medications prior to the procedure. These benefits make the procedure a feasible option for people with multiple comorbidities or increased surgical risk secondary to anesthesia.
“Another benefit is the small incision size and the minimally invasive, image-guided approach. Compared to the traditional approach, this procedure generally offers a faster recovery with limited downtime from work and hobbies.”
Rachael says the procedure went very smoothly for her.
“It was super easy,” she says. “They made sure I was very well taken care of. They kept me calm. It was super quick; he explained everything as he was doing it. It was pain-free. It was easy-peasy, and then I got up and walked out.”
Within a week of the procedure, Rachael noticed a major improvement in her symptoms and was able to start baking again.
“As soon as I could use my hand again, I realized there was no more tingle, no more pain,” she says. “I wasn’t waking up in the middle of the night with pain. I didn’t have to wear my brace. I could move my hand normally. I could hold my phone. I could hold things in my hand.”
A Thriving Baker
Two years after her procedure, Rachael has full use of her hand and wrist. She opened the ice cream shop this year to complement the bakery, which will celebrate its five-year anniversary in 2026.
“I can decorate cookies again,” Rachael says. “I’m scooping ice cream, which I definitely wouldn’t have been able to do beforehand.”
Without the procedure, Rachael says, she would’ve had to go back to an office job.
“I would have never been able to be a small-business owner and thrive with what I do,” she says.
Rachael’s story is one of many successful ultrasound-guided carpal tunnel releases that Dr. Sweiss has performed.
“We have been doing the ultrasound-guided carpal tunnel releases for over three years now, and this continues to be a very successful procedure with great outcomes and patient experience,” Dr. Sweiss says.
Rachael says the care she received from Dr. Sweiss and his team was “fantastic.” She encourages anyone struggling with carpal tunnel symptoms to get the minimally invasive procedure.
“I recommend Dr. Sweiss to everybody,” she says. “Anybody that literally says anything about carpal tunnel, I’m like, ‘Oh, call Dr. Sweiss. Let me give you his information.’”
Dr. Sweiss is a board-certified neurosurgeon at UPMC Neurological Institute in Williamsport. In addition to carpal tunnel, he specializes in the diagnosis and surgical treatment of degenerative, traumatic, and oncologic spinal conditions.