Predictive factors in the non-surgical treatment of carpal tunnel syndrome

Abstract

To identify which patients are likely to respond the medical management of carpal tunnel syndrome, 331 hands in 229 patients were evaluated. They were then treated with a wrist splint and anti-inflammatory medication. Follow-up averaged 15.4 months (minimum six months). Treatment was successful in 18.4%. Statistical evaluation identified five factors which were important in predicting response to treatment: age over 50 years, duration over ten months, constant paraesthesiae, stenosing flexor tenosynovitis, and a Phalen's test positive in less than 30 seconds. When none of these factors was present, two-thirds of patients were cured by medical therapy. 59.6% of patients with one factor, 83.3% with two factors, and 93.2% with three factors failed. No patient with four or five factors present was cured by medical management.

The Effectiveness of Carpal Bone Mobilization Accompanied by Night Splinting in Idiopathic Carpal Tunnel Syndrome

“…The specific choice of therapy will also vary according to patient preference and availability. For patients with mild to moderate CTS, conservative therapy is generally considered to be a reasonable first option with successful outcomes ranging from 20% to 93% (5)(6)(7). One review showed good results for splinting, ultrasound, nerve gliding exercises, carpal bone mobilization, magnetic therapy, and yoga for people with carpal tunnel syndrome (8).…”

Eficacia de la gabapentina en el tratamiento del síndrome del túnel carpiano

“…Las limitaciones de estas opciones farmacoterapéuticas han motivado el estudio de otros tratamientos como los antiepilépticos, entre ellos la gabapentina. El estudio de Kaplan et al 5 demostró que el fracaso del tratamiento conservador se asociaba de forma más significativa a pacientes con edad mayor de 50 años, con más de 10 meses de duración de los síntomas, parestesias constantes y Phallen positivo a los 30 s. Por otro lado, aunque la cirugía en el STC generalmente se considera segura y efectiva, en ciertos casos, debido a los posibles riesgos asociados al acto quirúrgico, puede preferirse el tratamiento conservador 6 . Según Gerritsen et al 3 , la descompresión quirúrgica parece ser más efectiva que la férula de descarga de muñeca en períodos de seguimiento de hasta 18 meses.…”

The impact of tourniquet on patient satisfaction in carpal tunnel decompression

“…Patient evaluation measure [3] was used to assess the patient satisfaction. A telephone interview was carried out and patients were asked the standard questions as mentioned in patient evaluation measure after explaining the process to them.…”

“…A large number of patients fail to respond to conservative treatment with wrist splints, analgesics, lifestyle modification and corticosteroid injection [3]. In this group of patients, surgical release of flexor retinaculum is indicated in order to decompress the carpal tunnel, as first described by Learmonth in 1933 [4].…”