Use of conservative therapy before and after surgery for carpal tunnel syndrome

Abstract

Background Conservative therapies are typically offered to individuals who experience mild or intermittent symptoms of carpal tunnel syndrome (CTS) or postoperatively to subjects who have undergone carpal tunnel release. Although long-term studies report mostly positive results for carpal tunnel release, knowledge on the need for conservative treatments following surgery is scarce. The aim of this retrospective cohort study was to examine the use of conservative therapies before and after carpal tunnel releasing surgery. Methods Of 528 patients who underwent carpal tunnel release surgery in the study hospital during the study period, 259 provided sufficiently completed questionnaires (response rate 49 %). The patients completed a questionnaire battery including a sociodemographic, medical history and symptom questionnaire, the Boston Carpal Tunnel Syndrome Questionnaire, 6-item CTS symptoms scale and EuroQoL 5D. Frequencies of conservative therapies pre- and postoperatively were calculated. Association between Pain VAS and satisfaction with treatment were examined in patient groups according to the use of conservative therapies. Results Of all patients, 41 (16 %) reported receiving only preoperative, 18 (7 %) reported receiving only postoperative, 157 (60 %) reported receiving both pre- and postoperative conservative therapies and 43 (17 %) did not receive any therapies. Preoperative use of conservative therapies was more common in females than males (82 % vs. 64 %; p = 0.002), but postoperatively no significant gender difference was observed. The patients who received conservative therapies were younger than non-users in both the preoperative (median age 59 vs. 66; p < 0.001) and postoperative (59 vs. 66; p = 0.04) phases. The patients reported high satisfaction with their treatment and simultaneous improvement in Pain VAS scores. Those receiving conservative therapies only preoperatively reported the highest satisfaction. Conclusions While the use of conservative therapies decreased after surgery, a large proportion of the patients received these adjunct interventions. Patients reported high satisfaction with their treatment one year post surgery. Pain outcome seems to be closely related to satisfaction with treatment. Level of Evidence Level III.

Use of Sonophoresis with Corticosteroids in Carpal Tunnel Syndrome: Systematic Review and Meta-Analysis

“…The prevalence of women observed during this review, as well as the subjects’ range age, is in line with the epidemiological studies carried out in the past [ 36 , 37 , 38 , 39 ]. The presence of a higher quantity of women may be due to their prevalence in types of employment prone to suffer from this pathology [ 39 ].…”

Significance of Early Diagnostic of Carpal Tunnel Syndrome

“…Even though there are advantages of the surgical treatment method, it is necessary to take into consideration possible complications of those as well. Therefore, conservative treatment remains the first line for the treatment of mild and moderate CTS (Multanen, J., et al 2021). These facts were motivating for us to examine the degree of the median nerve damage at the moment when our patients report for the first time in order to electrodiagnostically confirm suspicions of CTS and if it is still possible to have the conservative treatment.…”

Skin closUre in carPal tunnEl Release (SUPER): protocol for a blinded randomised controlled trial comparing absorbable and non-absorbable sutures in carpal tunnel release

“…While non-operative treatment is the primary option, invasive treatment is often necessary. According to a recent study, 77% of patients undergoing median nerve release surgery had previously received some form of non-operative treatment 6. Carpal tunnel release surgery is considered the gold standard and has been shown to give excellent results in 75% of cases 7.…”

“…According to a recent study, 77% of patients undergoing median nerve release surgery had previously received some form of nonoperative treatment. 6 Carpal tunnel release surgery is considered the gold standard and has been shown to give excellent results in 75% of cases. 7 Another study found a significant reduction in Symptom Severity Scale for 88% of patients treated.…”