If you’ve been living with numbness, tingling, or pain in your hand or wrist, you might be among the millions affected by carpal tunnel syndrome (CTS). Traditionally, surgery for carpal tunnel has meant a trip to the hospital or operating room and longer recovery times,. What if you could get relief — safely and effectively — right in your doctor’s office?

The Good news is that a new, minimally invasive procedure using ultrasound guidance can now be done in a community clinic or out-patient-surgery center, without needing a hospital or general anesthesia. It’s fast, safe, and designed to get you back to life sooner.

What Is Carpal Tunnel Syndrome?

Carpal tunnel syndrome happens when the median nerve — which runs from your forearm into your hand — gets compressed at the wrist [Wipperman & Penny, 2024; Malakootian et al, 2023; Wipperman & Goerl, 2016].

This compression leads to a range of symptoms, including:

• Tingling or numbness in the fingers (especially thumb, index, and middle fingers)

• Weakness or clumsiness in the hand

• Pain that may extend up the arm

It often affects people who do repetitive hand movements, such as typing, manual labor, or assembly work — but it can happen to anyone [Currie et al, 2022; LeBlanc & Cestia, 2011].

Traditional Carpal Tunnel Surgery: What’s the Catch?

Surgery has always been the most effective long-term treatment for moderate to severe CTS.

However, traditional open carpal tunnel surgery (OCTR) has several potential drawbacks that may influence patient decisions to delay or avoid the procedure. These include:

• Need for a hospital or surgery center visit: OCTR typically requires a visit to a hospital or surgery center, which can be inconvenient for patients [Teng et al, 2019; MacDonald & Rea, 2022].

• General or regional anesthesia: OCTR often necessitates general or regional anesthesia, which carries inherent risks and may be a concern for some patients [Teng et al, 2019; MacDonald & Rea, 2022; Sayegh & Strauch, 2015; Li et al, 2020].

• Longer recovery times: Compared to endoscopic techniques, OCTR is associated with longer recovery periods, delaying the return to work and daily activities [Teng et al, 2019; MacDonald & Rea, 2022; Sayegh & Strauch, 2015; Li et al, 2020].

• Larger incisions and scarring: OCTR involves larger incisions, leading to more noticeable scarring and a higher risk of scar tenderness and pillar pain [Teng et al, 2019; MacDonald & Rea, 2022; Sayegh & Strauch, 2015; Li et al, 2020].
  

• More time off work: Patients undergoing OCTR generally require more time off work compared to those undergoing endoscopic carpal tunnel release (ECTR) [Teng et al, 2019; MacDonald & Rea, 2022; Sayegh & Strauch, 2015; Li et al, 2020].

Understandably, many patients delay or avoid surgery due to fear of the procedure or its costs and inconvenience. Patients often delay or try to avoid surgery due to several factors:

• Fear of the procedure: Concerns about the surgical process, potential complications, and postoperative pain can deter patients from opting for surgery [Gong et al, 2009].
• Costs: The financial burden associated with surgery, including hospital fees, anesthesia costs, and potential loss of income during recovery, can be significant [Bernstein et al, 2021].
• Inconvenience: The need for multiple visits, preoperative assessments, and postoperative follow-ups can be inconvenient, especially for those with busy schedules or limited access to healthcare facilities [Gong et al, 2009; Bernstein et al, 2021].

• Over 90% reported symptom improvement at follow-ups
  
• No major complications occurred (no infections, no nerve or tendon injuries)
  
• Patients were satisfied with the experience, and many had both hands treated
  
• Even those with multiple health conditions or previous surgeries did well.
  

Patients appreciated being able to have the procedure close to home and resume daily activities quickly.

What Makes This Procedure Different?

Here’s what you can expect from a carpal tunnel release under ultrasound guidance (using the Sonex-Microknife):

Local Anesthesia Only: You stay awake during the procedure. Just a numbing injection at the wrist — no IVs, no general anesthesia, no grogginess afterward.

Tiny Incision, Minimal Scarring: A small, 4–5 mm incision is made — about the size of a pea. Thanks to ultrasound, your doctor can guide the instrument with precision, avoiding unnecessary tissue damage.

Fast Recovery: Most patients are back to normal activities within 3–5 days, with many reporting major symptom relief almost immediately.

Covered by Insurance: Yes, the procedure is covered by Medicare and most major insurers.

Who Is a Good Candidate?

This in-office carpal tunnel procedure is ideal if:

• You have moderate to severe symptoms of carpal tunnel syndrome

• You’ve tried conservative treatments (like wrist splints or injections) without relief

• You’d prefer to avoid a hospital setting

• You want a quick recovery and minimal disruption to your life

A quick ultrasound evaluation can help determine if you're eligible. The technology allows doctors to visualize your anatomy in real-time and plan the safest approach.

Frequently Asked Questions

Q: Is the procedure painful?
A: Most patients feel little to no pain during the procedure. Local anesthetic keeps the area numb, and some patients describe only mild pressure.

Q: How long does it take?
A: The actual release takes only a few minutes.

Q: Will I need stitches?
A: No! The incision is so small that it usually just needs a bandage and heals quickly on its own.

Q: When can I go back to work?
A: It depends on your job. Many return to light activities within a few days, while heavy labor jobs may require a bit more time.

Want to know if you're a candidate for a minimally invasive carpal tunnel release?

If you’ve been putting off treatment due to fear of surgery or recovery time, this might be the solution you’ve been waiting for. Contact our clinic today to schedule a consultation and find out how we can help you get back to doing what you love — pain-free.

(781) 591-7855

info@BSBortho.com

20 Walnut St

Suite 14

Wellesley MA 02481

References:

Bergum RA, Ciota MR. Office-Based Carpal Tunnel Release Using Ultrasound Guidance in a Community Setting: Long-Term Results. Cureus. 2022 Jul 23;14(7):e27169.

Bernstein DN, Gruber JS, Merchan N, Garcia J, Harper CM, Rozental TD. What Factors Are Associated with Increased Financial Burden and High Financial Worry For Patients Undergoing Common Hand Procedures? Clin Orthop Relat Res. 2021 Jun 1;479(6):1227-1234.

Currie KB, Tadisina KK, Mackinnon SE. Common Hand Conditions: A Review. JAMA. 2022 Jun 28;327(24):2434-2445.

Gong HS, Baek GH, Oh JH, Lee YH, Jeon SH, Chung MS. Factors affecting willingness to undergo carpal tunnel release. J Bone Joint Surg Am. 2009 Sep;91(9):2130-6.

LeBlanc KE, Cestia W. Carpal tunnel syndrome. Am Fam Physician. 2011 Apr 15;83(8):952-8.

Li Y, Luo W, Wu G, Cui S, Zhang Z, Gu X. Open versus endoscopic carpal tunnel release: a systematic review and meta-analysis of randomized controlled trials. BMC Musculoskelet Disord. 2020 Apr 27;21(1):272.

MacDonald E, Rea PM. A Systematic Review of Randomised Control Trials Evaluating the Efficacy and Safety of Open andEndoscopic Carpal Tunnel Release. Adv Exp Med Biol. 2022;1356:141-172.

Malakootian M, Soveizi M, Gholipour A, Oveisee M. Pathophysiology, Diagnosis, Treatment, and Genetics of Carpal Tunnel Syndrome: A Review. Cell Mol Neurobiol. 2023 Jul;43(5):1817-1831.

Sayegh ET, Strauch RJ. Open versus endoscopic carpal tunnel release: a meta-analysis of randomized controlled trials. Clin Orthop Relat Res. 2015 Mar;473(3):1120-32.

Teng X, Xu J, Yuan H, He X, Chen H. Comparison of Wrist Arthroscopy, Small Incision Surgery, and Conventional Surgery for the Treatment of Carpal Tunnel Syndrome: A Retrospective Study at a Single Center. Med Sci Monit. 2019 Jun 3;25:4122-4129.

Wipperman J, Goerl K. Carpal Tunnel Syndrome: Diagnosis and Management. Am Fam Physician. 2016 Dec 15;94(12):993-999.

Wipperman J, Penny ML. Carpal Tunnel Syndrome: Rapid Evidence Review. Am Fam Physician. 2024 Jul;110(1):52-57.