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Hand & Wrist · Office-Based

Carpal tunnel release with real-time ultrasound guidance

Carpal tunnel syndrome compresses the median nerve, causing numbness, tingling, and weakness. Using real-time ultrasound, we release the ligament through an incision just a few millimeters wide — with a faster, more comfortable recovery.

Book an Appointment → Call (808) 439-6201

Long-term results are comparable to open or endoscopic release. Candidacy is confirmed at your visit.

Black-and-white photograph of an elegant, open hand

Benefits vs. traditional surgery

  • Smaller incision, minimal scarring
  • Faster recovery and return to work
  • Less post-operative pain and swelling
  • High precision with real-time visualization

Understanding the Condition

What is carpal tunnel syndrome?

Carpal tunnel syndrome (CTS) is one of the most common problems affecting the hand, afflicting an estimated 13 million Americans with numbness and tingling in the hands and fingers. It develops when the median nerve is compressed inside the carpal tunnel — a narrow passage at the wrist whose roof is formed by the transverse carpal ligament. Left untreated, it can cause long-term debilitation.

Carpal tunnel release (CTR) treats the condition by dividing the transverse carpal ligament, creating more space for the nerve and tendons and relieving pressure on the median nerve.

Common symptoms

  • Numbness or tingling in the thumb, index, or middle finger
  • Symptoms that wake you at night
  • Symptoms while driving or holding a phone
  • Weakness or clumsiness of the hand

Educational, not a diagnosis. Similar symptoms can come from the neck or other nerve problems — an exam confirms the cause.

Conservative Care First

Surgery isn't the first step

For milder or early symptoms, we usually start with non-surgical care. Carpal tunnel release is considered when conservative measures no longer control symptoms — or when nerve compression is more advanced. Not everyone is a candidate for surgery, and we'll tell you honestly which step you're at.

Night splinting

A wrist brace worn at night keeps the wrist in a neutral position, easing pressure on the nerve while you sleep.

Activity modification

Adjusting the positions and repetitive tasks that provoke your symptoms can meaningfully reduce them.

Injections, when appropriate

A corticosteroid injection can calm symptoms for a time and help confirm the diagnosis.

A wrist brace used for night splinting in carpal tunnel syndrome
A night splint keeps the wrist neutral while you sleep — often the first treatment for milder symptoms.

How It Works

Precise, and often in-office

Real-time ultrasound gives the surgeon a live view of the median nerve, tendons, and ligament throughout the release — improved visualization of all critical anatomy through a small, less disruptive wrist incision.

01

Ultrasound mapping

Real-time imaging locates the nerve, tendon, and ligament with precision.

02

Tiny incision

Through an incision often only a few millimeters wide, the transverse carpal ligament is released.

03

Quick recovery

Most patients resume light activity within days, with relief of tingling and numbness.

Handheld device designed for carpal tunnel release with real-time ultrasound guidance
A handheld device designed for carpal tunnel release with real-time ultrasound guidance, used with real-time imaging.
Graphic reading 'Carpal tunnel syndrome — recovery in days, not weeks'
Most patients resume light activity within days.

The Patient Experience

What the procedure — and recovery — feel like

Many people delay treatment for carpal tunnel syndrome because they're intimidated by surgery, worried about recovery time, or concerned about cost. Real-time ultrasound guidance was designed to address exactly those concerns.

Office-based for eligible patients

Performed in a procedure room or office setting — often avoiding the hospital and general anesthesia.

Local anesthesia

The procedure is typically performed using local anesthesia; the release itself is generally performed in minutes.

Small wrist incision

A small, less disruptive wrist incision — usually closed without sutures.

Recovery in days — not weeks or months

Back in days

Most patients can return to work and the activities they love within 3–5 days. Individual recovery varies.

Immediate motion

You can move your hand right away, which supports a rapid recovery.

Therapy typically not required

Post-operative hand therapy is typically not needed — saving you time and money.

Simple pain control

The technique reduces or eliminates the need for opioids — most patients manage with Tylenol® or ibuprofen.

UltraGuideCTR™ is a trademark of Sonex Health, Inc. Carpal tunnel release with UltraGuideCTR may not be appropriate for all patients, and not all patients may benefit. Talk with your doctor about the benefits and risks and whether it's right for you. Individual recovery varies.

Ultrasound-Guided Release by the Numbers

Why real-time ultrasound guidance changes the recovery math for carpal tunnel release.

6 mm
Median Wrist Incision
TUTOR randomized trial: mean 6 mm at the wrist vs 22 mm palm incision for mini-open (Eberlin et al., Expert Rev Med Devices 2023)
~4
Median Days to Return to Work
TUTOR trial reported a median return to work of about 3-4 days after ultrasound-guided release (Eberlin et al., 2023); individual recovery varies
88%
Satisfied at 13 Years
Long-term follow-up of carpal tunnel release: 88% completely or very satisfied at a mean 13 years (Louie et al., J Bone Joint Surg Am 2013)
Local
Anesthesia, Office-Based
Ultrasound-guided release is performed under local anesthesia — no hospital or general anesthesia required (Eberlin et al., TUTOR trial, 2023)
Median days to return to work, by technique
Median time patients took to return to work after carpal tunnel release in published randomized trials.
Open & endoscopic (RCT) Ultrasound-guided (RCT)
Open release 38 days
Endoscopic release 18 days
Ultrasound-guided release ~4 days
Open vs. endoscopic: Trumble et al., J Bone Joint Surg Am 2002;84(7):1107-15 — prospective randomized trial, median return to work 38 days (open) vs 18 days (endoscopic). Ultrasound-guided: Eberlin et al. (TUTOR trial), Expert Rev Med Devices 2023 — median return to work ~3-4 days. Individual recovery varies.

Watch

Our new carpal tunnel treatment, explained

See how carpal tunnel release with real-time ultrasound guidance works at Pacific Bone & Joint — and why recovery is measured in days, not weeks.

By Location

Carpal tunnel release with real-time ultrasound guidance near you

The only group offering this technique on the Big Island — Hilo & Kona — plus our Oahu clinics.

HonoluluWaipahuHiloKona

Evidence & Research

What the evidence says about carpal tunnel release with real-time ultrasound guidance

Ultrasound guidance lets the surgeon release the carpal tunnel through a very small opening while watching the nerve in real time. Here is a plain-language summary of what peer-reviewed research and the American Academy of Orthopaedic Surgeons report — with honest limits.

Carpal tunnel syndrome is the most common compressive nerve condition in the hand. When night splints and injections no longer control symptoms, releasing the transverse carpal ligament reliably relieves them for most patients.1

Ultrasound-guided release is done through a tiny opening using real-time imaging to protect the nerve. In a randomized clinical trial it was associated with a faster return to normal activities than conventional open release.2

In prospective studies, carpal tunnel release performed with real-time ultrasound guidance showed high rates of symptom relief and a low complication rate, with quick functional recovery.3

Carpal tunnel release is durable: most patients get lasting relief, and releasing the nerve earlier may help prevent permanent damage in more severe cases. Individual results vary.4

The procedure is performed in-office under local anesthesia for eligible patients. Severe or long-standing nerve compression may limit how fully symptoms recover. Not everyone is a candidate, and individual results vary. This page is educational and is not a substitute for medical advice.

References

  1. American Academy of Orthopaedic Surgeons (AAOS), OrthoInfo. Carpal Tunnel Syndrome & Carpal Tunnel Release Surgery. Accessed 2026. View source ↗
  2. Rojo-Manaute JM, Capa-Grasa A, Chana-Rodríguez F, et al. Ultra-minimally invasive ultrasound-guided carpal tunnel release: a randomized clinical trial. J Ultrasound Med. 2016;35(6):1149–1157. View source ↗
  3. Petrover D, Silvera J, De Baere T, et al. Percutaneous ultrasound-guided carpal tunnel release: study upon clinical efficacy and safety. Cardiovasc Intervent Radiol. 2017;40(4):568–575. View source ↗
  4. American Academy of Orthopaedic Surgeons. Management of Carpal Tunnel Syndrome: Evidence-Based Clinical Practice Guideline. 2016. View source ↗

2-Minute Check

Am I a candidate for carpal tunnel release with real-time ultrasound guidance?

Answer a few quick questions. This is educational and is not a diagnosis — only an evaluation can tell for sure.

Do you have numbness or tingling in your thumb, index, or middle finger?

Do symptoms wake you at night or worsen when driving or holding a phone?

Have splints or injections stopped helping?

Answer all 3 questions to see your result.

Patient Reviews

What patients say

“I am absolutely grateful for the care I received from Dr. Morton and his staff! Truly blessed that he was called to perform the surgery on my wrist shortly after my injury.”

— Leona K.· Google review

“Fell and broke my wrist. He came into the emergency department and set it. I’m about 4 months out and it feels like nothing happened. Thank you!”

— Verified patient· RateMDs review

Review excerpts reflect individual patient experiences and may be lightly condensed. Results vary.

Questions, Answered

Frequently asked questions

How is this different from traditional carpal tunnel surgery?+

It uses real-time ultrasound and a few-millimeter incision instead of a larger open incision — which can mean less scarring, less pain, and a faster return to work, with comparable long-term results.

Is it done in the office?+

In many cases, yes — carpal tunnel release with real-time ultrasound guidance can be performed in a procedure room or office setting, typically using local anesthesia and avoiding the hospital and general anesthesia. We'll confirm what's right for you.

How soon can I use my hand?+

You can move your hand immediately, and most patients return to work and the activities they love within 3–5 days. Individual recovery varies; your care team will give you specific guidance.

Will my numbness go away?+

Many patients experience significant relief of tingling and numbness; recovery varies by how long the nerve was compressed. Left untreated, carpal tunnel syndrome can cause long-term debilitation — which is why an evaluation is worth having early.

Do I have to try splints or injections first?+

Often, yes. Milder symptoms are frequently managed with night splinting, activity modification, and sometimes an injection. Carpal tunnel release is considered when conservative care no longer controls symptoms or nerve compression is more advanced. We'll be honest about which step you're at.

Is this a new or experimental technique?+

No. Carpal tunnel release performed under ultrasound guidance was first documented in 1997, and the UltraGuideCTR™ device has been used clinically since 2017. Long-term results are comparable to open or endoscopic release.

Will I need hand therapy afterward?+

Post-operative therapy is typically not required — saving time and money. We'll let you know if your particular situation calls for it.

Is carpal tunnel release covered by insurance?+

Carpal tunnel release is covered by Medicare and most private insurance companies. We recommend confirming coverage with your plan before treatment — our team can help.

Numbness or tingling in your hand?

Book an evaluation and find out whether ultrasound-guided release is right for you.

Book an Appointment → Call (808) 439-6201
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