Carpal tunnel syndrome: assessment of the need for rehabilitation and recovery treatment after endoscopic decompression of the median nerve in the late and long-term postoperative periods

Abstract

Background. Carpal tunnel syndrome is the most common tunnel neuropathy in which the median nerve is compressed at the level of the wrist in the carpal canal. Treatment of carpal tunnel syndrome can be conservative and surgical. Surgical treatment is indicated in case of ineffective conservative treatment. However, the strategy of managing patients with carpal tunnel syndrome in the postoperative period has not yet been determined; there is no clear understanding of the effectiveness and necessity of rehabilitation in the early and long-term postoperative periods.Aim. Follow-up the patients after decompression of the median nerve in the late (up to 3 weeks after surgery) and long-term (3 weeks after surgery) postoperative periods to assess the effectiveness of different methods of rehabilitation.Materials and methods. A randomized controlled study included 108 cases of idiopathic carpal tunnel syndrome (unilateral and bilateral). After surgery, the patients were divided into three groups: the restorative treatment group using magnetic therapy, the kinesiotherapy group, and the control group. Clinical, neurophysiological and ultrasound monitoring was carried out for six months.Results. Patients of all the groups showed similar improvement in the most of the analyzed parameters, without any significant difference.Conclusion. Thus, according to the results of a comprehensive study, it is evident that early diagnosis of carpal tunnel syndrome and a high-quality surgical decompression of the median nerve with a complete dissection of the flexor retinaculum of the hand guarantee improvement within six months or later after surgical treatment without additional rehabilitation measures.