Splinting for carpal tunnel syndrome

Karjalainen, Teemu; Lusa, Vieda; Page, Matthew J.; O’Connor, Denise; Massy‐Westropp, Nicola; Peters, Susan E.

doi:10.1002/14651858.cd010003.pub2

Cited by 12 publications

(7 citation statements)

References 120 publications

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“…The severity of symptoms can be assessed by any of the scales available [34,38]. Conservative treatment should be proposed to all patients, either as definite treatment or until ENG or surgery [39]. Criteria for ENG referral: OR ≥2 for neuropathy with sensory and motor involvement (≥3).…”

Section: Discussionmentioning

confidence: 99%

“…According to a recent Cochrane review, even small benefits with splitting seem to justify its use in patients. The benefits would manifest in long-term use [39]. The algorithm could also reduce current ENG demand in patients with a low risk of sensory-motor neuropathy, and this could also have an impact by shortening the waiting time for ENG in those patients at high risk of sensory-motor neuropathy.…”

Section: Discussionmentioning

confidence: 99%

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A Proposal for Neurography Referral in Patients with Carpal Tunnel Syndrome Based on Clinical Symptoms and Demographic Variables of 797 Patients

Vázquez-Sánchez,

Gómez-Menéndez,

López-Veloso

et al. 2024

Diagnostics

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The clinical manifestation of median nerve entrapment at the carpal tunnel level is known as carpal tunnel syndrome (CTS). Electroneurography (ENG) is considered the gold standard in CTS evaluation. We conducted a retrospective study and analyzed some clinical and demographic variables, relating them to the degree of neuropathy using ENG, to better understand the role of ENG in this very common disease. We studied 816 patients referred to our service for neurographic evaluation. Their symptoms were classified as compatible with CTS (cCTS) (n = 646) and atypical for CTS (aCTS) (n = 170). A blind ENG was performed on 797 patients. Patient characteristics were coded as variables and analyzed to study whether they could predict neuropathy severity (sensory and motor involvement or grade ≥ 3 in our classification). We found a correlation between typical symptomatology, age over 50 years, male gender, positivity of Phalen’s maneuver and Tinel’s sign, and a neuropathy grade ≥ 3. We also found a correlation with CTS in the contralateral hand if the other hand showed neuropathy, despite the lack of symptoms in this hand. We propose a practical algorithm for ENG referral based on clinical symptoms, demographic factors, and neurophysiological variables.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A Proposal for Neurography Referral in Patients with Carpal Tunnel Syndrome Based on Clinical Symptoms and Demographic Variables of 797 Patients

Vázquez-Sánchez,

Gómez-Menéndez,

López-Veloso

et al. 2024

Diagnostics

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“…Therefore, kinesio taping appears to be a valid and recommended intervention complementary to other therapies to obtain greater effectiveness rather than a stand‐alone therapy in patients with CTS. Some of these conventional therapies comprise neurodynamic techniques for decreasing pain and functionality (de Arenas‐Arroyo et al., 2021), shock waves for functionality (with contradictory outcomes for pain at present) (Chen et al., 2022; Xie et al., 2020), the use of splints to improve functionality, severity, and the neurophysiological aspects studied in this pathology (Karjalainen et al., 2023). Therefore, the combination of techniques within a conventional treatment plan appears to be a valid approach to address all the clinical signs of this pathology whose beneficial effects have been shown to be only slightly inferior to those of surgical treatment (Shi et al., 2020).…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, kinesio taping appears to be a valid and recommended intervention complementary to other therapies to obtain greater effectiveness rather than a stand-alone therapy in patients with CTS. Some of these conventional therapies comprise neurodynamic techniques for decreasing pain and functionality (de Arenas-Arroyo et al, 2021), shock waves for functionality (with contradictory outcomes for pain at present) (Chen et al, 2022;Xie et al, 2020), the use of splints to improve functionality, severity, and the neurophysiological aspects studied in this pathology (Karjalainen et al, 2023).…”

Section: Discussionmentioning

confidence: 99%

Short‐term effectiveness of kinesio taping as therapeutic tool in conservative treatment of carpal tunnel syndrome: A systematic review and meta‐analysis

Tomás‐Escolar,

Merino‐Andrés,

Sánchez‐Sierra

et al. 2023

Physiotherapy Res Intl

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Background and Purpose: Carpal tunnel syndrome is the most common peripheral neuropathy of the upper extremities and kinesio taping is one of the tools used as a complementary tool within the conventional treatment of carpal tunnel syndrome.To investigate the short-term effects of kinesio taping on pain, functionality, strength, and nerve conduction in subjects suffering from carpal tunnel syndrome.Methods: Systematic review with meta-analysis. Seven electronic databases

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“…According to a recent systematic review in Cochanrce, whether splints should be worn full-time or only at night and whether long-term use is preferable to short-term use remain unclear. However, low-quality evidence suggests that benefits will be realized with long-term use ( Karjalainen et al, 2023 ). Therefore, local injections combined with splinting may contribute to improved results.…”

Section: Discussionmentioning

confidence: 99%

Local injection therapy for carpal tunnel syndrome: a network meta-analysis of randomized controlled trial

Zhou,

Wu,

Gou

et al. 2023

Front. Pharmacol.

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Objective: Clinical research has shown that local injections for carpal tunnel syndrome reduce the symptoms of patients and enhance their quality of life considerably. However, there are several therapy options, and the optimal choice of regimen remains uncertain. Therefore, we comprehensively evaluated the variations in clinical efficacy and safety of several medications for treating carpal tunnel syndrome.Methods: Computer searches of Embase, PubMed, Cochrane Library, and Web of Science databases were used to collect articles of randomized controlled trials on local injections for treating carpal tunnel syndrome from database creation till 10 June 2023. Two researchers independently screened the literature, extracted information, evaluated the risk of bias in the included studies, and performed network Meta-analysis using Stata 17.0 software. Drug efficacy was assessed using symptom severity/function and pain intensity. Surface under the cumulative ranking curve (SUCRA) ranking was used to determine the advantage of each therapy.Results: We included 26 randomized controlled trials with 1896 wrists involving 12 interventions, such as local injections of corticosteroids, platelet-rich plasma, 5% dextrose, progesterone, and hyaluronidase. The results of the network meta-analysis showed the following: (i) symptom severity: at the 3-month follow-up, D5W combined with splinting (SUCRA = 95%) ranked first, and hyaluronidase (SUCRA = 89.6%) at 6 months; (ii) functional severity: either at the 3-month follow-up (SUCRA = 89.5%) or 6 months (SUCRA = 83.6%), iii) pain intensity: 5% dextrose in water combined with splinting was the most effective at the 3-month (SUCRA = 85%) and 6-month (SUCRA = 87.6%) follow-up.Conclusion: Considering the combination of symptoms/function and pain intensity, combining 5% dextrose in water with splinting is probably the treatment of choice for patients with carpal tunnel syndrome. It is more effective than glucocorticoids and no adverse effects have been observed.Systematic Review Registration:https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42022370525.

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Splinting for carpal tunnel syndrome

Cited by 12 publications

References 120 publications

A Proposal for Neurography Referral in Patients with Carpal Tunnel Syndrome Based on Clinical Symptoms and Demographic Variables of 797 Patients

A Proposal for Neurography Referral in Patients with Carpal Tunnel Syndrome Based on Clinical Symptoms and Demographic Variables of 797 Patients

Short‐term effectiveness of kinesio taping as therapeutic tool in conservative treatment of carpal tunnel syndrome: A systematic review and meta‐analysis

Local injection therapy for carpal tunnel syndrome: a network meta-analysis of randomized controlled trial

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