10-20
minutes
Procedure time
0
incisions
Truly blade-free
3x
faster
Return to work vs open surgery
2
bandaids
That's all you need
How Thread Carpal Tunnel Release Works
A simple procedure using a needle and thread — guided by ultrasound for precision.
1
Numbing
Local anesthetic is injected in the wrist and palm. You stay awake and comfortable — no IV, no sedation.
2
Thread Placement
Using ultrasound to see every structure in real time, Dr. Dashe guides a thin thread beneath and then above the transverse carpal ligament through two tiny needle entry points. No incision is made.
3
Ligament Release
The abrasive thread is gently moved back and forth to divide the ligament, relieving pressure on the median nerve. The ultrasound confirms a complete release in real time.
4
Done — Two Bandaids
The needle entry points are covered with a soft dressing. No stitches needed. Within a few days, just two bandaids are all you need. You walk out the same day. Total procedure time: about 10–20 minutes.
How Does Thread Compare?
Not all carpal tunnel procedures are the same. Here's how they stack up.
| Feature |
Thread (TCTR) |
Open Surgery |
Endoscopic |
Sonex UltraGuideCTR |
| Incision |
None (needle only) |
2–3 cm cut |
1–2 small cuts |
Small cut (~4mm) |
| Blade / Scalpel |
No blade at all |
Scalpel |
Internal blade |
Retractable micro-blade |
| Stitches |
None |
Yes (removal needed) |
Yes |
Steri-strips or 1 stitch |
| Anesthesia |
Local only |
Local or sedation |
Local or sedation |
Local |
| Return to Work (avg) |
12 days |
33 days |
~25 days |
~14 days |
| Pillar Pain |
Minimal |
Common |
Less common |
Less common |
| Scar |
None |
Visible scar |
Small scars |
Small scar |
Thread vs. Sonex UltraGuideCTR
Both are ultrasound-guided — but the mechanism is fundamentally different.
Thread Release (TCTR)
- Uses an abrasive thread — no blade of any kind
- Divides the ligament gradually under real-time ultrasound
- Two needle punctures — no skin incision, no scar
- Significantly less post-operative pain and pillar pain
- Only truly incisionless approach available
Sonex UltraGuideCTR
- Uses a retractable micro-blade inside a device
- Single cut to divide the ligament
- Requires a small skin incision (~4mm)
- May require steri-strips or a stitch
- Still a blade-based approach
The key difference: Thread is the only truly incisionless, blade-free carpal tunnel release available.
Recovery After Thread Release
Day of procedure: You go home the same day. Move your fingers normally. An initial soft dressing is applied and can be removed in a few days — then just bandaids.
Office workers: Most return to typing and desk work within 1–5 days.
Manual labor: Average return to full duty in 12 days (compared to 33 days for open surgery).
~90% of non-manual-labor patients are back to work within 1 week.
No formal physical therapy is needed in most cases.
Pillar pain and scar tenderness — common complaints after traditional surgery — are significantly reduced with the Thread technique.
The Only Thread Release Provider in the Bay Area
Dr. Jesse Dashe is the only surgeon in the San Francisco Bay Area offering Thread Carpal Tunnel Release. This procedure is otherwise primarily available at Mayo Clinic and select centers nationally. Patients come from Oakland, San Francisco, Fremont, Hayward, Castro Valley, and beyond.
Frequently Asked Questions
What is Thread Carpal Tunnel Release?
Thread Carpal Tunnel Release (TCTR) is an incisionless, in-office procedure that uses an abrasive thread guided by ultrasound to release the transverse carpal ligament. No scalpel, blade, or stitches are needed — just two needle entry points covered by bandaids.
How is Thread Release different from regular carpal tunnel surgery?
Traditional carpal tunnel surgery requires a 2–3 cm incision, stitches, and sedation. Thread Release uses no incision at all — just a needle and thread under ultrasound guidance, performed under local anesthesia in about 10–20 minutes.
Does Thread Release use a blade or scalpel?
No. Thread Release is completely blade-free. An abrasive thread is used to divide the ligament. This is different from other minimally invasive approaches like the Sonex UltraGuideCTR, which still uses a retractable micro-blade.
How long does the procedure take?
The procedure typically takes about 10–20 minutes. It is performed under local anesthesia — no IV, no sedation.
How soon can I go back to work?
Most office workers return to work within 1–5 days. Approximately 90% of non-manual-labor patients are back to work within one week. Manual laborers average about 12 days, compared to 33 days for traditional open surgery.
Will carpal tunnel come back after Thread Release?
Thread Carpal Tunnel Release achieves complete division of the transverse carpal ligament, confirmed by ultrasound in real time during the procedure. Published studies show excellent long-term outcomes.
Does insurance cover Thread Carpal Tunnel Release?
Thread Carpal Tunnel Release is a recognized treatment for carpal tunnel syndrome. Coverage varies by insurance plan. Our office can help verify your benefits before scheduling.
How is Thread different from the Sonex device?
Both are ultrasound-guided, but Sonex uses a retractable micro-blade and requires a small skin incision. Thread uses an abrasive thread with no blade and no incision — just two needle punctures. Thread is the only truly incisionless, blade-free approach.
Where can I get Thread Carpal Tunnel Release in the Bay Area?
Dr. Jesse Dashe at East Bay Hand Medical Center in San Leandro is the only provider of Thread Carpal Tunnel Release in the San Francisco Bay Area. The procedure is otherwise primarily available at Mayo Clinic and select centers nationally.
What does recovery look like?
You go home the same day. An initial soft dressing is applied and can be removed in a few days — then just bandaids. Move your fingers normally right away. Most patients do not need formal physical therapy. Pillar pain and scar tenderness — common after traditional surgery — are significantly reduced.
