Ultrasound-guided acupotomy: a paradigm shift toward precision and safety in carpal tunnel syndrome therapy

Effective management of carpal tunnel syndrome requires balancing therapeutic efficacy with procedural safety. Traditional acupotomy, while minimally invasive, is limited by its dependence on non-visualized techniques that can lead to inaccurate anatomical targeting and potential complications. Ultrasound guidance overcomes these limitations by enabling real-time visualization of key anatomical structures during the procedure. This approach facilitates precise, targeted release of the transverse carpal ligament while minimizing risks to neurovascular tissues. This perspective outlines the theoretical basis, clinical evidence, and practical implementation of ultrasound-guided acupotomy. Available data suggest this method enhances functional recovery while improving patient experience through greater procedural transparency. The integration of imaging guidance provides a pathway toward standardizing this minimally invasive intervention. Further validation through rigorous clinical studies and the establishment of structured training protocols will support its appropriate integration into clinical practice for carpal tunnel syndrome management.