Carpal Tunnel Syndrome Explained

What is Carpal Tunnel Syndrome (CTS)?

Affecting more than 12 million people nationwide, CTS can cause pain, numbness, and tingling in the hand and arm. It occurs when the median nerve, one of the major nerves in the arm, is compressed as it travels through the carpal tunnel in the wrist by the trans carpal ligament (TCL).

How is Carpal Tunnel Syndrome Diagnosed?

CTS can be diagnosed clinically based on the patient’s symptoms supported by physical exam findings. It can also be diagnosed with Nerve Conduction Studies, Electromyography, or with an ultrasound machine.

How is Carpal Tunnel Syndrome Treated?

Initially, CTS can be treated with bracing, stretching, behavioral modification, and NSAIDs. It may also be treated with steroid or platelet injections. However, if symptoms persist it is typically treated with a surgical procedure to cut the ligament of the carpal tunnel and give the nerve more space.

Traditional Carpal Tunnel Release Surgery

CTS surgery is called carpal tunnel release (CTR), which relieves pressure on the median nerve by cutting the transverse carpal ligament. Traditional CTR procedures can remedy the condition but may result in large and sometimes painful scars, ongoing palmar pain, and a longer road to recovery.

A New Way to Treat Carpal Tunnel Syndrome for Faster Recovery

Now there’s a proven way to get rapid relief from carpal tunnel pain and return quickly to normal activities.

Micro-invasive Carpal Tunnel Release (CTR)

This procedure involves a low-profile, safe, and effective instrument that allows your doctor to perform carpal tunnel release in a matter of minutes. When combined with ultrasound visualization, the procedure requires only a very small (3-4 mm) wrist incision.

Significant Benefits of the Micro-invasive Procedure

  • Performed in a procedure room or office setting
  • Can be performed using local anesthesia
  • Small wrist incision is typically closed without sutures
  • Reduces or eliminates the need for opioids
  • Postoperative therapy is typically not required—saving you time and money
  • Immediate motion in the hand for rapid recovery
  • Return to normal activity in a few days, not months

After the procedure, you’ll be able to resume activities as tolerated—most patients can return to work and the activities they love within 3-6 days.

Micro-invasive CTR under Ultrasound Guidance

  1. A 4 mm micro-incision is made in the wrist.
  2. Under ultrasound guidance, the device is inserted through the micro-incision.
  3. Small water-filled balloon barriers are deployed in the “safe zone” to enhance the protection of nearby nerves, tendons, and other sensitive anatomy during the procedure.
  4. The small blade is unsheathed after being positioned under ultrasound guidance and cuts the TCL in the wrist to reduce pressure in the carpal tunnel thereby removing the compression on the median nerve and resolving the symptoms in the hand.

The device is removed and the micro-incision is closed with an adhesive bandage or strip. 

If you or someone you know is interested in this innovative procedure, please contact us today


  1. Nakamichi K, Tachibana S, Yamamoto S, et al. Percutaneous carpal tunnel release compared with mini-open release using ultrasonographic guidance for both techniques. J Hand Surg Am. 2010 Mar;35(3):437-445. 
  2. Rojo-Manaute JM, Capa-Grasa A, Chana-Rodriguez F, et al. Ultra-minimally invasive sonographically guided carpal tunnel release: a randomized clinical trial. J Ultrasound Med. 2016 Jun;35(6):1149-1157.
  3. Henning PT, Yang L, Awan T, et al. Minimally invasive ultrasound-guided carpal tunnel release: preliminary clinical results. J Ultrasound Med. 2018 Nov;37(11):2699-2706.
About The Author
Ignatios Papas, DO

Ignatios Papas, DO

Ignatios Papas, DO, is a non-surgical orthopedic physician specializing in Physical Medicine and Rehabilitation at Regenexx® at New Regeneration Orthopedics.
Ignatios Papas, DO

Ignatios Papas, DO

Ignatios Papas, DO, is a non-surgical orthopedic physician specializing in Physical Medicine and Rehabilitation at Regenexx® at New Regeneration Orthopedics.

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