Gentle, Ultrasound-Guided Surgery Under Local Anesthesia with Dr. Matthias Spiegl

Modern treatment of carpal tunnel syndrome in Salzburg and Pixendorf

What is carpal tunnel syndrome?

Carpal tunnel syndrome (CTS) is a common compression injury of the median nerve at the wrist. It manifests as tingling, numbness, or pain in the thumb, index, and middle fingers, which typically occurs at night.
In advanced stages, it can lead to a loss of strength and muscle wasting in the ball of the thumb (thenar eminence). Timely treatment is therefore crucial to prevent permanent nerve damage.

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• Modern treatment methods with Dr. Spiegl
• Consultation & appointment scheduling
• Minimal-invasive surgery for carpal tunnel syndrome
• Process and healing phase
• Advantages of ultrasound-guided carpal tunnel surgery
• Costs & patient education
• Your specialist for hand and nerve surgery in Salzburg and Pixendorf
• Frequently asked questions about carpal tunnel syndrome (FAQ)

Modern treatment methods with Dr. Spiegl

Depending on the stage of carpal tunnel syndrome, both conservative and surgical treatment options are available. In mild cases, a night splint for the wrist or infiltration therapy can initially help alleviate symptoms. However, these measures usually provide only temporary relief, meaning that for most cases of carpal tunnel syndrome, surgery—specifically a surgical decompression of the median nerve—is indicated.

Consultation & appointment scheduling

If you are interested in carpal tunnel surgery, you are welcome to arrange a consultation appointment with Dr. Spiegl. During your first appointment, questions will be answered without any time pressure, comprehensive advice will be provided, and photo documentation will be prepared.
In addition, an ultrasound scan will be performed to determine whether you are a suitable candidate for the new surgical method that does not require a classic skin incision. You should definitely bring all available medical reports (especially the findings from a neurologist) from your medical history. If you decide to proceed with the surgery with Dr. Spiegl after receiving the cost estimate, a date for the operation will be agreed upon together.

Minimal-invasive surgery for carpal tunnel syndrome

Dr. Matthias Spiegl generally performs the procedure under local anesthesia—gentle, painless, and on an outpatient basis. Thanks to his extensive training in hand surgery and modern technology, the procedure can, in many cases, be performed under ultrasound guidance and almost without a skin incision.

With this minimal-invasive method, the division of the carpal ligament is carried out precisely under ultrasound control. This eliminates the need for a larger incision, which accelerates healing and minimizes scar formation. If an ultrasound-guided procedure is not possible due to anatomical conditions, a “classic” mini-open technique is used. In this case, too, the incision is only about 2.5 cm long.

Note: Currently, the ultrasound-guided surgery is only performed at the Pixendorf practice!

Process and healing phase

Surgery details

• Duration of surgery: approx. 20–30 minutes
• Anesthesia: local infiltration anesthesia
• Type of procedure: outpatient
• Technique: ultrasound-guided, minimal-invasive surgery without a large incision (if anatomically feasible), otherwise mini-open technique

Healing phase

• Fit for work (light activities): after approx. 3–5 days
• Removal of sutures / wound check: after 10–14 days
• Hand exertion: can be gradually increased after 1–2 weeks
• Final result: after about 6–8 weeks (however, complete nerve recovery can take a year or longer)

Patients benefit from short downtime, minimal scarring, and a rapid restoration of hand function.

Advantages of ultrasound-guided carpal tunnel surgery

• Local anesthesia – no general anesthesia required
• Minimal-invasive, often without a visible scar
• Low risk of wound healing complications
• Shorter recovery time and less postoperative pain
• Precise, safe technique through direct ultrasound monitoring

Costs & patient education

The exact costs of carpal tunnel surgery depend on the chosen technique and individual findings—in the vast majority of cases, a cost of **€2,000** is to be expected.
In a personal consultation, the diagnosis, surgical method, costs, recovery time, and aftercare will be discussed in detail. Dr. Spiegl places particular emphasis on transparent and patient-centered education so that every decision can be made on a well-informed basis.

Your specialist for hand and nerve surgery in Salzburg and Pixendorf

Dr. Matthias Spiegl is a specialist in Plastic, Reconstructive, and Aesthetic Surgery and holds Austrian, Swiss, and British medical licenses. Following his highly specialized international training with residencies in England, Switzerland, and Scotland, he settled in Salzburg and Lower Austria.

As an additional qualification, Dr. Spiegl completed the European Board Exam in 2018 and is entitled to call himself a “Fellow of the European Board of Plastic, Reconstructive and Aesthetic Surgery” (FEBOPRAS). This additional qualification is rare, especially in Austria, and further distinguishes him as an expert. Dr. Spiegl is a member of numerous national and international professional societies, which serves as an additional quality feature:

• International Society of Aesthetic Plastic Surgery (ISAPS)
• Austrian Society for Plastic, Aesthetic and Reconstructive Surgery
• Swiss Society for Plastic, Reconstructive and Aesthetic Surgery
• Fellow of the European Board of Plastic, Reconstructive and Aesthetic Surgery
• General Medical Council (United Kingdom)
• Fellow of the American College of Surgeons (FACS)

Frequently asked questions about carpal tunnel syndrome (FAQ)

Is the surgery painful?

No. The operation is performed under local anesthesia. The area is completely pain-free, and patients remain awake and responsive throughout.

How long does the healing take?

Light activities can be resumed after just a few days. After 3–4 weeks, the hand is usually fully resilient. However, complete regeneration of the nerve can take up to a year.

Will a scar remain?

With the ultrasound-guided method, often only a tiny puncture scar remains. With classic procedures, a small incision of about 2–3 cm is made in the palm of the hand, which is barely noticeable later on.

Can carpal tunnel syndrome return?

Generally no, but recurrences are not impossible. After complete division of the carpal ligament, the pressure on the nerve is relieved; however, sometimes unfavorable scar formation occurs, and symptoms may persist.