The investigators are comparing two standard of care procedures which can be performed at the same time, or sequentially. The hypothesis being tested is whether simultaneous release of both the carpal Tunnel and the Pronator Teres results in a better outcome in terms of symptom relief and recurrence than Carpal Tunnel Release alone when signs and symptoms of both carpal tunnel and pronator Teres syndromes are present.

• Inclusion Criteria: Positive Tinnels signs over the median nerve at the Carpal Tunnel and Pronator Teres
• Normal two point discrimination
• Over the age of 18 and under the age of 65

Exclusion Criteria:

• Peripheral neuropathy of the median nerve secondary to trauma
• Presence of thoracic outlet syndrome
• Presence of cervical disk disease
• Under the age of 18 and over the age of 65