Common symptoms
- Comprehensive hand & wrist evaluation
- Same-day imaging at most offices
- Conservative-first care plan tailored to your goals
- Coordinated specialty referrals when needed
- In-network insurance for most major carriers
Wide-Awake Hand Surgery: no IV, no fasting, and home the same hour.
Many hand and wrist procedures at LAOSS are done with local anesthesia only: no IV sedation, no general anesthesia, no tourniquet. The technique is called WALANT (Wide-Awake Local Anesthesia No Tourniquet), and it changes the recovery experience entirely.
See a specialist this week
Board-certified surgeons and podiatrists across eight Los Angeles area neighborhoods.
Book a visitOr call (323) 264-7600
Key takeaways
- Local anesthesia only: no IV sedation, no general anesthesia, no tourniquet.
- No fasting required. Eat normally before your appointment.
- Same-hour return home for most cases, no recovery room observation.
- You're awake and can talk to your surgeon during the procedure: they can ask you to move the hand to verify the repair.
About wide-awake hand surgery (WALANT)
Wide-Awake Hand Surgery (WALANT) is part of the hand & wrist care we offer at LAOSS. Below, we walk through the anatomy involved, who benefits from this service, what it looks like at our clinics, and the recovery and risk considerations to weigh.
Our specialists move stepwise: start with the least-invasive option that fits, escalate only when it doesn't.
Watch: What Does a Hand Surgeon Do?
Your hands are highly complex and sensitive organs. The hand's bones, muscles, nerves, blood vessels and other soft tissues can be damaged by injury or disease. Hand surgeons are doctors who specialize in these issues. They make sure your hands, wrists, and forearms work well.
Inside the hand & wrist.
The hand and wrist are an intricate stack of small bones, tendons, and nerves that let you grip, pinch, and feel.
What we offer with wide-awake hand surgery (WALANT).
Common causes
- New patients exploring an orthopedic complaint
- Existing LAOSS patients continuing care
- Patients seeking a second opinion
- Athletes and active adults of every age
How we start treatment
When you book with LAOSS for wide-awake hand surgery (WALANT), here's the flow:
- Initial visit: detailed history, focused exam, on-site X-ray when needed
- Diagnosis & plan: most patients leave with imaging-confirmed answers and a written treatment plan
- Treatment: whether that's PT, an injection, or surgery, your specialist stays involved at every step
- Follow-up: measured benchmarks, direct line to your care team, plan adjustments as recovery progresses
Hand & wrist care, conservative-first.
We start with the least-invasive option that fits, and escalate only when it doesn't.
Conservative care
Step 1Conservative care first
Non-surgical options designed to relieve pain, restore movement, and avoid the OR when possible.
- Custom splinting & bracing
- Image-guided steroid injections
- Hand therapy with a certified hand therapist (CHT)
- Activity & ergonomic modification
- PRP for chronic tendinopathy
Surgical care
When neededSurgical options when needed
Minimally invasive and reconstructive procedures performed by board-certified orthopedic surgeons.
- Wide-awake (WALANT) hand surgery
- Carpal tunnel release
- Trigger finger release
- Wrist or thumb joint reconstruction
- Fracture fixation
Why experience matters.
Why experience matters
Hand & wrist care is highly technique-dependent. Volume, training, and judgment together determine the outcome you feel six months later.
- Precise diagnosis from imaging and exam
- Conservative-first care that avoids unnecessary surgery
- Technique refined over thousands of cases
- On-site imaging + coordinated PT through your in-network provider
The LAOSS approach
Our hand & wrist specialists move stepwise: start with the least-invasive option that fits, escalate only when it doesn't.
- Same-day imaging at most offices
- PT coordinated in your insurance network
- Board-certified specialists performing the procedures themselves
- Direct access to your specialist between visits
Am I a candidate?
If most of these match your situation, an evaluation with a hand & wrist specialist is the next step.
You may be a candidate if
These signs typically point toward this service being a good fit.
- Hand & wrist pain or dysfunction lasting more than a few days
- Swelling, instability, or noticeable change in function
- Symptoms that limit walking, lifting, sleep, or work
- Previous treatment that didn't fully resolve the problem
- Imaging or exam findings that suggest an underlying issue
What evaluation includes
Your first visit is built to give you an answer the same day, not just another referral.
- Detailed history: onset, mechanism, what makes it better or worse
- Hands-on exam focused on the affected joint or region
- On-site imaging at most offices (X-ray, ultrasound)
- Clear plan with options ranging from conservative to surgical
- Same-day or next-day scheduling for any follow-up tests
ImportantSeek urgent evaluation for sudden severe pain, numbness, progressive weakness, or any sign of infection (fever, increasing redness or swelling).
Your hand & wrist recovery roadmap.
Recovery is rarely a straight line, but a clear plan with measurable milestones makes the path predictable.
- Days 0 to 14
Right after care
In the first two weeks we focus on protecting the hand & wrist, calming inflammation, and restoring basic motion.
- Activity modification with clear do/don't guidance
- Ice, elevation, and pain control as needed
- Gentle range-of-motion within safe limits
- Follow-up scheduled to track healing
- Weeks 2 to 8
Rehabilitation
Targeted physical therapy rebuilds strength, mobility, and confidence in the hand & wrist.
- Progressive strengthening and neuromuscular work
- Manual therapy and soft-tissue treatment
- Sport- or job-specific movement re-training
- Coordinated PT through your in-network provider
- Months 2+
Long-term care
Once function is restored, the focus shifts to keeping you there, and catching any recurrence early.
- Return-to-activity plan with measured benchmarks
- Home program tailored to your sport or job
- Maintenance visits or imaging if symptoms change
- Direct line back to your specialist if needed
Risks & considerations
What to weigh before you decide.
We talk through the risks and benefits with every patient. Informed consent is a conversation, not a form.
General considerations
Every orthopedic intervention carries a small set of standard risks. We screen, prepare, and monitor for these on every patient.
- Infection (rare with modern technique and prophylaxis)
- Bleeding or bruising at the treatment site
- Reaction to anesthesia or medications
- Need for additional procedures in some cases
Hand and wrist considerations
Some risks are tied to the structures we're treating in the hand & wrist. We discuss these in detail at your visit so you can weigh them against the benefits.
- Temporary stiffness or weakness during recovery
- Incomplete pain relief in a small percentage of cases
- Nerve or vessel irritation near the treatment area
- Need for follow-up therapy to fully restore function
Meet our hand & wrist specialists
At LAOSS, our hand & wrist specialists are board-certified and treat these problems every day. From minimally invasive techniques to coordinating your rehab, our physicians bring decades of experience to every case. We have cared for Los Angeles patients since 2007, with one goal for each: less pain, better movement, and a return to the activities you love.
Reliable wide-awake hand surgery starts here
With same- or next-day appointments at eight Los Angeles-area offices, you'll never wait weeks or months for answers. Whether you need physical therapy, injections, or surgery, we plan it with you and coordinate each step.
Call or schedule online today to see a hand & wrist specialist in Los Angeles.
Wide-awake hand surgery: FAQ.
- The surgery itself should not hurt. The local anesthetic numbs the surgical area completely before any incision is made. Most patients describe it as feeling pressure or movement but no pain. Many sleep, listen to music, or chat with the surgeon during the procedure.
Book a hand consult with LAOSS.
Our hand surgeons will evaluate your condition and let you know whether wide-awake surgery is the right approach. Same-week appointments available at our East LA, Wilshire, Tarzana, Encino, and Glendale offices.
Booking now
21 specialists · 8 offices
Greater Los Angeles
On-site X-raySame visit
Most insurers acceptedIn-network