Abstract
Carpal tunnel syndrome (CTS) is the most common upper extremity compression neuropathy. Non-operative interventions are usually the first-line treatments, and surgery is reserved for those that do not achieve a satisfactory symptom state by non-operative means. This narrative review summarizes the current evidence regarding the efficacy of orthoses, corticosteroid injections, platelet-rich plasma injections, Kinesio taping, neurodynamic techniques, gabapentin, therapeutic ultrasound, and extracorporeal shockwave therapy in people with CTS. While many trials suggest small short-term benefits, rigorous evidence of long-term patient-important benefits is limited. To improve the utility of healthcare resources, research in this area should focus on establishing efficacy of each treatment instead of comparing various treatments with uncertain benefits.
Highlights
Carpal tunnel syndrome (CTS) is a common compression neuropathy of the median nerve at the wrist level where the nerve passes through the carpal tunnel together with the finger flexor tendons
We will provide up-to-date data regarding the efficacy of orthoses, corticosteroid injections, platelet-rich plasma injections, Kinesio taping, neurodynamic techniques, gabapentin, therapeutic ultrasound, and Extracorporeal Shock Wave Therapy (ESWT) for CTS
While corticosteroid injection slightly decreases the risk of surgery during the first year, it may not decrease the rate of surgery when the follow-up continues for years
Summary
Carpal tunnel syndrome (CTS) is a common compression neuropathy of the median nerve at the wrist level where the nerve passes through the carpal tunnel together with the finger flexor tendons. Pooled data from six different studies (n = 4321) suggested a prevalence of 8% among workers [2]. RCTs have assessed the effect of various non-operative treatments in people with CTS, but often studies compare one treatment with another not addressing the question whether the interventions are better than doing nothing, i.e., their efficacy. In this narrative review, we will provide up-to-date data regarding the efficacy of orthoses, corticosteroid injections, platelet-rich plasma injections, Kinesio taping, neurodynamic techniques, gabapentin, therapeutic ultrasound, and ESWT for CTS
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