Surgical versus non-surgical treatment for carpal tunnel syndrome

Diagnosis, treatment and follow-up of the carpal tunnel syndrome: a review

“…There are three randomised controlled studies that compare surgical versus conservative treatment [40][41][42], two of which were included in a systematic Cochrane review [43]. In the studies included in the review [40,42], the non-surgical group had been treated by hand-wristforearm splinting for 4 or 6 weeks.…”

“…In any case, it must be underlined that in this study, after 18 months 41% of patients in the splinting group had undergone surgical treatment. The reviewers concluded that, although short-term (1 month) statistical data were only mildly significant, surgical treatment is more effective than conservative therapies in preserving mid-to long-term improvement [43]. In the study by Ly-pen et al [41], the non-surgical group underwent steroid treatment by local infiltration.…”

The effects of active release technique on carpal tunnel patients: A pilot study

“…10 A Cochrane database review on nonsurgical versus surgical treatments for CTS concluded surgery was the better approach, however, wrist splinting was the only non-surgical treatment included in the review. 11 Napadow et al 12 had 6 CTS patients undergo 5 weeks of acupuncture and evaluated changes in functional MRI, nerve conduction and Boston Questionnaire (BQ) scores. The patients experienced improvements in subjective and objective measures following the acupuncture intervention.…”

Early Surgical Decompression Restores Neurovascular Blood Flow and Ischemic Parameters in an in Vivo Animal Model of Nerve Compression Injury

“…Recent clinical data have shown that early surgical management of carpal tunnel syndrome has better efficacy and produces better long-term outcomes compared with more conservative medical approaches, such as injections, anti-inflammatory agents, and splinting [4][5][6][7] . If surgical decompression is to be performed, it has been suggested that the timing of the surgery is also an important parameter for optimizing functional recovery 8 .…”

“…If surgical decompression is to be performed, it has been suggested that the timing of the surgery is also an important parameter for optimizing functional recovery 8 . Although surgical decompression often ameliorates the symptoms of carpal tunnel syndrome when performed early in the disease course by reversing the sensory dysfunction, there is limited understanding of why surgical intervention is less effective when performed at later time points and has limited effect on reversing the motor atrophy that develops later in the disease course 4,5,7,9 . Currently, electrophysiology is considered important for making the diagnosis of carpal tunnel syndrome 10,11 .…”