Effectiveness of Conservative Treatment According to Severity and Systemic Disease in Carpal Tunnel Syndrome: A Systematic Review.

José Miguel Tricás-Moreno,Sami Hamam-Alcober,Raquel Montaña-Cortés,María Orosia Lucha-López,Mar Hernández-Secorún,Jaime Corral-De-Toro,César Hidalgo-García,Jacobo Rodríguez-Sanz,Sofia Monti-Ballano

doi:10.3390/ijerph18052365

Abstract

(1) Background: Carpal tunnel syndrome (CTS) is the most common peripheral neuropathy in the upper extremity. Conservative treatment has been effective for mild and moderate idiopathic CTS. However, severe CTS and systemic conditions were an exclusion criterion from the studies. The aim of this study is to review the effectiveness of conservative treatment in patients with CTS regardless of the level of severity and the presence or not of systemic diseases in the last ten years. (2) Methods: Randomized controlled clinical trials that compared the effect of conservative treatment on the Boston questionnaire and pain were selected. PubMed, PEDro, Scopus, Cochrane, and Web of Science databases were used. PRISMA statement checklist was performed. (3) Results: 876 studies were recorded, 29 were selected. Pharmacology, Electrotherapy and Manual Therapy had benefits for CTS. Electrotherapy and manual therapy could be effective for severe CTS patients with a systemic condition in the short term, but there was a low percentage of these patients included in the studies. (4) Conclusion: Some pharmacological treatments, manual therapy and electrotherapy have shown benefits for handling CTS, although the most effective combination of techniques is unknown. It would be necessary to include patients with systemic conditions in the selection criteria for future studies.

Highlights

The Population was people suffering from Carpal tunnel syndrome (CTS); the Intervention was conservative treatment such as manual therapy, exercise, electrotherapy or pharmacology; the Comparison was Control, Placebo or other therapies; the Outcome was pain and function; and the Study Design was Randomized Controlled Trial
Our study objective was to review the effectiveness of conservative treatment in patients with CTS of any level of severity, with the inclusion of patients with systemic conditions
In patients with mild and moderate CTS, electrotherapy seems to be effective following treatment as long as it is combined with splinting, but its effectiveness is no greater than manual therapy

Summary

Introduction

Carpal tunnel syndrome (CTS) is defined as an entrapment of the median nerve in the carpal tunnel in the wrist, generally associated with an increase in carpal tunnel pressure [1]. It is the most common peripheral neuropathy in the upper quadrant. The prevalence for CTS ranges from 3.8% to 4.9%, with women being three times more predisposed than men [1,2]. The elevated prevalence of this pathology causes annual healthcare costs to rise, increasing the socioeconomic costs [3]

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Conclusion