Q&A

Nonsurgical treatment is effective for carpal tunnel syndrome

Author and Disclosure Information

  • CLINICAL QUESTION: Are nonsurgical approaches to carpal tunnel syndrome effective?
  • STUDY DESIGN: Systematic review
  • SETTING: Various (meta-analysis)
  • SYNOPSIS: These authors systematically reviewed English-language randomized controlled trials of non-surgical treatments of carpal tunnel syndrome. They did an exhaustive search of the literature, including Medline, EMBASE, the Cochrane Library, and the registry of controlled trials. They also hand-searched references from previously retrieved articles, and communicated with authors to obtain unpublished material.


 

BOTTOM LINE

In this systematic review, nonsurgical treatments of carpal tunnel syndrome using injected or oral steroids provided temporary relief. Spontaneous resolution is more common than you may think: nearly 50% of patients receiving placebos improved.

Long-term data on most treatments are lacking. In the few studies with long-term follow up, as many as 50% of patients had surgery during the first year after enrollment. (LOE=1a–)

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