Minimally Invasive Ultrasound-Guided Procedure Eases Carpal Tunnel Symptoms

The condition is linked to repetitive wrist and hand motion and affects roughly 5% to 10% of people over their lifetimes. Although corticosteroid injection can reduce swelling and nerve pressure, relief may be temporary and repeat procedures may be needed. To address the need for more durable treatment options, a new study shows that ultrasound-guided nerve hydrodissection may provide longer-lasting symptom relief without steroids.

Researchers at University College of Medical Sciences and Guru Teg Bahadur Hospital (Delhi, India) and Mahatma Gandhi Medical College and Hospital (Jaipur, India) evaluated ultrasound-guided hydrodissection for confirmed carpal tunnel syndrome. The technique involves injecting fluid around the affected median nerve under ultrasound guidance. This separates the nerve from surrounding adhesions and is intended to improve nerve mobility.

The prospective randomized controlled trial included 63 patients who had not responded to conventional treatment. Participants were divided into three equal groups. Two groups received ultrasound-guided hydrodissection of the median nerve, with one group treated with normal saline alone and the other receiving normal saline plus corticosteroid. A third group received ultrasound-guided corticosteroid injection alone.

Patients were evaluated with standardized symptom, function, and pain scores. Median nerve area was also assessed on ultrasound at four weeks, 12 weeks, and 24 weeks after treatment. All three groups improved significantly at four weeks, but the hydrodissection groups continued to improve during follow-up. Patients treated with corticosteroid injection alone had recurrent symptoms by 12 weeks and six months.

Adding corticosteroid to the hydrodissection injectate did not provide a significant long-term benefit compared with saline hydrodissection alone. Ultrasound findings showed that median nerve cross-sectional area decreased by approximately 43% to 45% after hydrodissection, compared with about 15% after corticosteroid injection alone, indicating less improvement in nerve swelling. The findings were published in Radiology, the journal of the Radiological Society of North America (RSNA), on October 6, 2026.

The procedure took an average of 15 minutes. No anesthesia or hospitalization was needed, and patients were able to return to work within an hour. No significant immediate or delayed complications were observed. Researchers stated that larger multicenter studies with longer follow-up are warranted, and they have launched a trial comparing injectates such as dextrose and saline.

“Overall, the study suggests that ultrasound-guided saline hydrodissection is a safe, minimally invasive treatment that can provide sustained clinical and morphological improvement in patients with refractory carpal tunnel syndrome,” said Anupama Tandon, M.D., professor in the Department of Radiodiagnosis and Imaging at University College of Medical Sciences and Guru Teg Bahadur Hospital in Delhi, India. “Thus, hydrodissection merits consideration as a minimally invasive option for mild to moderate carpal tunnel syndrome and can defer and even alleviate the need for surgery.”

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