Signs Of Carpal Tunnel Syndrome Research Articles

ELECTRODIAGNOSTIC CRITERIA FOR DIAGNOSING CARPAL TUNNEL SYNDROME NEED TO BE REVISED IN HYPOTHYROID PATIENTS

Background: Previous studies do not agree with each other on the association between electrodiagnostic findings and clinical symptoms of Carpal tunnel syndrome (CTS). In most of these studies, many variables such as age, sex, obesity and hypothyroidism have not been taken into account. Material & methods: About 62 patients with hypothyroidism and 62 patients without hypothyroidism with sign and symptoms of CTS were included in this study. Electrodiagnostic tests were done for all patients. And relationship of the severity of CTS signs and symptoms with electrodiagnostic parameters was examined statistically in each group. Results: This study showed that distal motor latency in control group (without hypothyroidism) is significantly more prolonged than hypothyroid patients. Also there was significant correlation between clinical symptoms and electrodiagnostic findings in control group, but there was not such correlation in hypothyroid patients. In 62% of hypothyroid patients with clinical signs and symptoms of CTS, electrodiagnostic findings were normal and only in 38% of cases, electrodiagnostic findings were suggestive of CTS. Conclusion: Relationship of the severity of CTS signs and symptoms with electrodiagnostic parameters is very weak in hypothyroid patients. Many hypothyroid patients with clinical signs and symptoms of CTS have normal electrodiagnostic findings; so we need more studies for revising the para-clinic criteria of labeling patients having CTS in hypothyroid patients.

A38 Physiotherapy of carpal tunnel syndrome

Carpal tunnel syndrome (CTS) is a widely distributed upper limb nerve compression. CTS is relatively easy to recognise with timely diagnosis of symptoms. The elimination of risks and professional conservative therapy can prevent the radical interventions. In our study we worked with 8 patients, 7 of them had signs of CTS in both hands. The diagnosis was based on history, physical examinations and an electroneurographia test (ENG). All of the patients completed a questionnaire about their subjective symptoms before the objective physical examinations. The used physiotherapy was modified for the severity of the symptoms. Advice on workplace task modification was given to all patients. Main symptoms are tingling, numbness, nocturnal pain and weakness in the distribution of the median nerve in the hand. Objective results represented a decrease in the range of motion, waste of force in the hand and thenar atrophy. After the treatment the waste of the abductor pollicis has disappeared in all patients, weakness and deficits of motion were found in one person. We recognised a significant improvement in the specific tests. Occupational factors, overstrain of the hands are important causes of CTS. Loss of sensory feedback and pain is more often presented than motor function loss. After the treatment the symptoms of patients were reduced or disappeared. CTS can be often effectively treated with complex physiotherapy and workplace task modifications, but there isn’t a complete recovery in all cases.

Work-related carpal tunnel syndrome treatment: a cross-sectional study among 106 patients.

The objective is to assess the influence of sociodemographic, professional and clinical variables on the choice of treatment of work-related carpal tunnel syndrome (CTS). An exhaustive and trans-sectional study was conducted over a period of eight years, from 1st January 2006 to 31 December 2013 in the Department of Occupational Medicine at University Hospital of Mahdia, Tunisia. The study population was represented by patients with work-related carpal tunnel syndrome. Data collection was based on a questionnaire sheet, describing social, occupational and medical characteristics of patients. The study population was characterized by a large female dominance, representing 95.3% with an average age of 42±7.8 years. Patients medically treated represented 38.7% and 61.3% had had surgical treatment. After binary logistic regression, surgical indication of CTS was significantly correlated to diabetes (p=0.017), other musculoskeletal disorders (p=0.02), functional signs of CTS (acrocyanosis p=0.05; muscle weakness p=0.015; radiating pain p=0.01; painful discomfort of the hand, the forearm or arm p=0.027) and to the atrophy of thenar muscles (p=0.018). According to this study, the choice of therapy for occupational CTS depends only on clinical data. More detailed studies will be needed to refine these results.

Strickland's hypothenar fat pad flap for revision surgery in carpal tunnel syndrome: Prospective study of 34 cases

Several techniques are available for revision surgery of carpal tunnel syndrome (CTS) to preserve a gliding layer and protect the median nerve, including Strickland's pedicled hypothenar fat pad flap. The objective of this single-center, prospective study was to report the results of this flap after a minimum follow-up of two years. Between March 2006 and April 2014, 34 patients were enrolled (mean age 67 years) who had postoperative complications after the primary surgical release of CTS with nighttime paresthesia and/or neuropathic pain and abnormal electromyography findings. All patients were operated on using the same technique: neurolysis of the median nerve in the carpal tunnel with the nerve protected by a Strickland flap. The preoperative and postoperative evaluations consisted of questionnaires (paresthesia, neuropathic pain using the VAS and DN4 score, QuickDASH) and a clinical examination (grip strength, Weber two-point discrimination, atrophy of thenar muscles). Eighteen patients were reviewed in person and sixteen over the telephone. The outcomes were analyzed after at least 24 months’ follow-up for all patients and 60 months for 13 patients. At 24 months postoperative, nighttime paresthesia was present in 3 of 34 patients and neuropathic pain in 2 of 24 patients. There was a significant reduction in pain on the VAS in all 34 patients (1.4 versus 6.4), the DN4 score (1.3 versus 5.7) and QuickDASH (60.7 versus 19.8). Of the 18 patients examined, grip strength improved from 72% to 86% of the opposite side (P<0.05), the mean static Weber was 6.4mm (versus 7.1mm preoperatively); nine patients had atrophy of the thenar muscles (versus eight preoperatively). The results observed at two years were maintained at five years’ follow-up. This flap appears to improve the subjective neurological signs of CTS.

A Rare Case of C8 Radiculopathy Due to Cervical Spine Synovial Cyst

Cervical spine synovial cysts are rare degenerative spinal abnormalities when compared to more frequently noticed degenerative cyst in the lumbar spine. Many times, cervical synovial cysts can be asymptomatic. However, as in the cervical spine, synovial cysts can cause nerve root compression and in the cervical spine can cause spinal cord compression, especially, when acute hemorrhage and/or a marked increase in the size of the cyst occurs, and thus, they can result in radiculopathy and/or myelopathy. The authors report a unique case of a 69-yearsold female who presented with a right C7-T1 synovial cyst causing right C8 radiculopathy and early myelopathy. This case is felt to be unique, because the diagnosis of the right C8 radiculopathy was confirmed on Electromyography (EMG) testing. The patient was also found not to have any signs of carpal tunnel syndrome. In addition, the diagnosis was further supported by a myelogram Computed Tomography (CT) scan done after the Magnetic Resonance Imaging (MRI). The MRI showed multiple levels of degenerative spondylosis, namely at C4-5, C5-6, and C6-7 with the question of stenosis at C7-T1, wrose on the right. The myelogram CT scan showed a much more clear-cut synovial cyst causing right sided C8 neural impingement and foraminal encroachment. Flexion/extension x-rays and the myelogram showed that the patient had a very minimal subluxation and a synovial cyst in the cervicothoracic junction is treated with spinal fusion. The authors showed, in the case, that even with slight subluxation, it is safe to treat a patient with a more minimally invasive C7-T1 laminotomy, foraminotomy and postoperative Flexion/extension x-rays and showed no sign of cervical instability after she was treated for her synovial cyst. She had nearly complete resolution of symptoms post operatively and did not develop instability in the follow-up period.

Exploring the Effectiveness of External Use of Bach Flower Remedies on Carpal Tunnel Syndrome: A Pilot Study.

A randomized, pilot, placebo-controlled clinical trial was conducted with the aim of evaluating the effectiveness of a cream based on Bach flower remedies (BFR) on symptoms and signs of carpal tunnel syndrome. Forty-three patients with mild to moderate carpal tunnel syndrome during their "waiting" time for surgical option were randomized into 3 parallel groups: Placebo (n = 14), blinded BFR (n = 16), and nonblinded BFR (n = 13). These groups were treated during 21 days with topical placebo or a cream based on BFR. Significant improvements were observed on self-reported symptom severity and pain intensity favorable to BFR groups with large effect sizes (η2partial > 0.40). In addition, all signs observed during the clinical exam showed significant improvements among the groups as well as symptoms of pain, night pain, and tingling, also with large effect sizes (φ > 0.5). Finally, there were significant differences between the blinded and nonblinded BFR groups for signs and pain registered in clinical exam but not in self-reports. The proposed BFR cream could be an effective intervention in the management of mild and moderate carpal tunnel syndrome, reducing the severity symptoms and providing pain relief.

Efficacy of kinesiotaping in patients with the initial signs of carpal tunnel syndrome

Background. Carpal tunnel syndrome (CTS) is one of the most common tunnel neuropathies. Early symptoms are often limited by periodic and slight discomfort in the area of innervation of a median nerve on the hand, so the patients are not willing to be treated invasively. Thus, a noninvasive therapy, such as kinesiotaping, could be perspective. Objective. Assessment of the efficiency of a kinesiotaping monotheraphy of patients on initial stage of CTS. Materials and methods. We included 120 patients with the initial stage of CTS: 51 men and 69 women aged from 24 till 54 years old. The main group included 70 people, and the control group – 50 patients. The main group was treated within 2 months by kinesiotaping only, control group was observed without any therapeutic intervention. Results. 60 % of the patients from the main group reported beneficial effect of kinesiotaping on clinical symptoms of the CTS. Conclusions. Kinesiotaping monotherapy at initial stages of CTS in our cohort relieves subjective symptoms in the majority of patients. To recommend kinesiotaping as an effective and safe method on initial stages of CTS to patients unwilling to undergo standard invasive treatment methods, a larger multicenter study is needed.

Electroneurographic monitoring during the test of artificial compression as a method of early diagnosis of carpal tunnel syndrome

To develop the algorithm of early diagnosis of carpal tunnel syndrome (CTS) at the stage of functional neurological disturbances by expanding diagnostic possibilities of electroneuromyography using artificial compression test. Parameters of conductivity of the median nerve in 54 patients with finger numbness were analyzed during 3 months before and after compression of the forearm (blood pressure was measured for 1 min). An increase in the latency in motor fibers and a decrease in the amplitude of sensory response were identified in patients with CTS signs and normal electroneuromyographical parameters at baseline. The use of additional electroneuromyographical monitoring during the provocative artificial compression test expands the possibilities of this method and improves early diagnosis of CTS.

Carpal Tunnel Syndrome in Hypothyroidism.

Carpal Tunnel Syndrome (CTS) is an entrapment neuropathy that occurs due to compression of median nerve in the carpal tunnel and hypothyroidism is one of the important causes of CTS. To study clinical profile of carpal tunnel syndrome in patients with primary hypothyroidism. This was cross-sectional study done in Smt. Kashibai Navale Medical College, Pune, Maharashtra. Adult patients with diagnosis of primary hypothyroidism were included in this study. Patients with other possible causes of CTS were excluded. Detailed medical history was obtained and all patients underwent clinical examination and nerve conduction study by electrophysiological method. Total 36 adult patients were included in this study, 86.1% females and 13.9% males. CTS were found in 6 (16.7%) patients. Increased Body Mass Index (BMI) and presence of clinical symptoms and/or signs of CTS correlated independently with presence of CTS in hypothyroidism. (p-value- 0.03 and < 0.0001 respectively). No correlation was found between gender, age of the patient, duration of disease, serum TSH level, aetiology of the disease, thyroid hormone replacement therapy and occurrence of CTS in hypothyroidism. Increase in BMI is an important risk factor for CTS in hypothyroidism and clinical evidence of CTS is a very sensitive parameter for the same.

The Utility of Semmes-Weinstein Monofilament Test in Detecting Carpal Tunnel Syndrome with Clinical Stage, Nerve Conduction Study, and Sonography Correlations

Background and purpose: Nerve conduction study (NCS) and ultrasonography (US) are used to support the diagnosis of carpal tunnel syndrome (CTS). The ability of the Semmes-Weinstein monofilament test (SWMT), a sensibility threshold test, to detect CTS, and its relationship to clinical severity, NCS, and US, remain controversial. We conducted this study to address this controversy. Method: Thirty-three patients presenting with typical symptoms and signs of CTS and 20 normal subjects were enrolled. SWMT on the index finger, NCS, and US of the cross-sectional area of the median nerve at the pisiform level (PCSA) were performed. Receiver operating characteristic (ROC) curves of SWMT, variables of NCS, and PCSA were plotted to analyze their discriminative utilities. The diagnostic agreement for CTS among SWMT, NCS, and PCSA were analyzed by kappa statistics. Sensitivities, specificities, positive predictive values (PPV), negative predictive values (NPV), and accuracies, as well as the correlation coefficients among SWMT, NCS measures, and PCSA, were calculated. Results: The areas under the ROC curve (AUC) for SWMT and PCSA were 0.852 and 0.71, respectively. AUCs for three NCS variables ranged from 0.822 to 0.902. All these variables were discriminative for CTS and were not significantly different in their discriminative power. SWMT yielded sensitivity, specificity, PPV, NPV, and accuracy of 82%, 70%, 82%, 70%, and 77%, respectively. There is significant agreement in detection of CTS using SWMT and NCS (kappa=0.575, p＜0.001). The kappas between SWMT and PCSA, as well as NCS and PCSA, were 0.305 and 0.427, respectively (p=0.025 and 0.002). SWMT significantly correlates with not only clinical stage, but also NCS measures and PCSA (r ranged from 0.381 to 0.581, p＜0.01). Conclusion: SWMT shows discriminative power similar to NCS and US for detection of CTS. SWMT also has a moderate correlation with clinical stage, NCS measures, and PCSA on US. As a painless, convenient, and inexpensive modality, SWMT may have the ability to diagnose CTS, but further research is needed.

Sonographic diagnosis of carpal tunnel syndrome: a study in 200 hospital workers.

ObjectiveTo describe the prevalence of carpal tunnel syndrome in a sample of 200 healthy hospital workers, establishing the respective epidemiological associations.Materials and MethodsTwo hundred individuals were submitted to wrist ultrasonography to measure the median nerve area. They were questioned and examined for epidemiological data, body mass index, carpal tunnel syndrome signs and symptoms, and submitted to the Boston carpal tunnel questionnaire (BCTQ) to evaluate the carpal tunnel syndrome severity. A median nerve area ≥ 9 mm2 was considered to be diagnostic of carpal tunnel syndrome.ResultsCarpal tunnel syndrome was diagnosed by ultrasonography in 34% of the sample. It was observed the association of carpal tunnel syndrome with age (p < 0.0001), paresthesia (p < 0.0001), Tinel’s test (p < 0.0001), Phalen’s test (p < 0.0001), BCTQ score (p < 0.0001), and years of formal education (p < 0.0001). Years of formal education was the only variable identified as an independent risk factor for carpal tunnel syndrome (95% CI = 1.03 to 1.24).ConclusionThe prevalence of carpal tunnel syndrome in a population of hospital workers was of 34%. The number of years of formal education was the only independent risk factor for carpal tunnel syndrome.

Concomitant presentation of carpal tunnel syndrome and trigger finger

BackgroundCarpal tunnel syndrome (CTS) and trigger finger (TF) are common conditions that may occur in the same patient. The etiology of most cases is unknown. The purpose of this study was to evaluate the rate of concomitant occurrence of these two conditions at presentation and to compare the concomitant occurrence in normal and diabetic patients.MethodsOne-hundred and eight consecutive subjects presenting to our hand clinic with CTS and/or TF were evaluated. The existence of both of these conditions was documented through a standard history and physical examination. The definition of trigger finger was determined by tenderness over the A1 pulley, catching, clicking or locking. CTS was defined in the presence of at least two of the following: numbness and tingling in a median nerve distribution, motor and sensory nerve loss (median nerve), a positive Tinel's or Phalen's test and positive electrophysiologic studies.ResultsThe average age of the participants was 62.2 ± 13.6 years. Sixty-seven patients presented with symptoms and signs of CTS (62%), 41 (38%) subjects with signs and symptoms of TF. Following further evaluation, 66 patients (61%) had evidence of concomitant CTS and TF. Fifty-seven patients (53% of all study patients) had diabetes. The rate of subjects with diabetes was similar among the groups (p = 0.8, Chi-square test).ConclusionCTS and TF commonly occur together at presentation though the symptoms of one condition will be more prominent. Our results support a common local mechanism that may be unrelated to the presence of diabetes. We recommend evaluation for both conditions at the time of presentation.

Perioperative consideration of general anesthesia for acromegalic patients.

Perioperative consideration of general anesthesia for acromegalic patients.

Electrophysiological assessment of hand elevation test in the diagnosis of carpal tunnel syndrome

Provided that the hand elevation test can reproduce the symptoms of carpal tunnel syndrome (CTS), this phenomenon prompted the idea of developing a simple test to diagnose CTS. The aim of this study was assess the electrophysiological values of the hand elevation test in the diagnosis of CTS syndrome. Thirty patients with initial symptoms and clinical signs of CTS in 49 hands were included. Special provocative tests for CTS were carried out before the hand elevation tests and the electrophysiological studies at least 5 min to avoid their effect on the intended test. The hand elevation test was performed and the test result was considered positive if symptoms occurred within 2 min. Nerve conduction study, including motor and sensory nerve conduction studies with F-wave study for both median nerves, was performed twice immediately before and after the hand elevation provocative test. This study was carried out on 60 hands; however, the initial complaint was in 49 hands, where the results showed a highly significant difference in parasthesia and hand pain, values of nerve conduction study (distal motor and sensory latencies) both before and after the hand elevation test, and a nonsignificant difference in the F-wave latencies. The posthand elevation distal motor and sensory latencies showed a sensitivity of 100 versus 78.6%, a specificity of 75 versus 81.2%, a positive predictive value of 77.8 versus 78.6%, and a negative predictive value of 100 versus 81.2%, respectively. Hand elevation is a simple provocative test that could be the physical examination of choice and can be used as a first-order provocative test instead of other tests for the diagnosis of CTS. Its significant provocative value was documented electrophysiologically.

The upper extremity musculoskeletal complications in dialysis patients: Comparison between hemodialysis and peritoneal dialysis

The aim of this study was to compare the upper extremity musculoskeletal complications in the patients who had been receiving hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD). The patients who had been receiving HD (n=17) or CAPD (n=15) were included to the study. The age, gender, duration of dialysis were recorded. The physical findings related to musculoskeletal system in the upper extremity were researched. The cervical, shoulder, hand standard radiographies and shoulder magnetic resonance imaging were investigated. The mean duration of HD and CAPD were 53.60 ± 36.03 and 49.17 ± 33.14 months, respectively (p=0.720). Only 6.3% of the CAPD group had signs of carpal tunnel syndrome (CTS). There were not any differences in the frequency of cervical destructive spondyloarthropathy, decreased height of vertebral corpus in the examination of cervical radiography (p=0.579) and also in the frequency of erosions in the humeral head and bones of hand, cyst in the clavicula, erosive osteoarthropathy and osteoporosis detected in the bones of hands (p> 0.005). In the examination of shoulder MR imaging, 80% of the HD group and 47.1% of the CAPD group had supraspinatus tendinitis (p=0.059). The frequency of subscapularis, biceps and infraspinatus tendinitis were not different in HD and CAPD groups (p> 0.05). The musculoskeletal system complications of the upper extremity were common in the patients undergoing dialysis therapy. The most common complications were osteoporosis of the hand region and supraspinatus tendinitis. Prospective, Level 2b.

Pain and Carpal Tunnel Syndrome

Pain is not a classical symptom of carpal tunnel syndrome (CTS), with the exception of numbness that is so intense that it is described by patients as painful. The primary aim of our study was to determine which factors correlated with pain for patients diagnosed with CTS. We prospectively assessed all patients diagnosed with CTS in our unit over a 1-year period. We recorded demographic details for all patients, including past medical history, body mass index, smoking, and occupation. The diagnosis and severity of carpal tunnel syndrome were established through a combination of history, clinical assessment, and nerve conduction studies. Of 275 patients diagnosed and treated for CTS, 183 were women (67%), the mean age was 55 years (range, 22-87 y), and 166 cases were bilateral (60%). The mean body mass index was 29.5 kg/m2 (range, 17-48 kg/m2), and 81 patients smoked (30%). Patients completed a Short Form-McGill pain questionnaire (SF-MPQ) as a measure of pain at initial presentation. We assessed outcome 1 year after intervention using the Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) score. We found no association between pain according to the SF-MPQ and the positive clinical signs of CTS or positive nerve conduction studies. Multivariate analysis demonstrated that smoking and bilateral disease independently correlated with the overall SF-MPQ, with similar findings on subanalysis. Independent factors associated with an increased improvement in the QuickDASH at 1 year were the presentation QuickDASH score, positive nerve conduction studies, and smoking. The only independent factors that correlated with pain at presentation of CTS were smoking and bilateral disease. Pain according to the SF-MPQ was not associated with classical clinical findings of the disease or with positive findings on nerve conduction testing. Prognostic I.

Fingertip necrosis as a sign of carpal tunnel syndrome

Fingertip necrosis as a sign of carpal tunnel syndrome

A study of interpolation method in diagnosis of carpal tunnel syndrome

Context:The low correlation between the patients’ signs and symptoms of carpal tunnel syndrome (CTS) and results of electrodiagnostic tests makes the diagnosis challenging in mild cases. Interpolation is a mathematical method for finding median nerve conduction velocity (NCV) exactly at carpal tunnel site. Therefore, it may be helpful in diagnosis of CTS in patients with equivocal test results.Aim:The aim of this study is to evaluate interpolation method as a CTS diagnostic test.Settings and Design:Patients with two or more clinical symptoms and signs of CTS in a median nerve territory with 3.5 ms ≤ distal median sensory latency <4.6 ms from those who came to our electrodiagnostic clinics and also, age matched healthy control subjects were recruited in the study.Materials and Methods:Median compound motor action potential and median sensory nerve action potential latencies were measured by a MEDLEC SYNERGY VIASIS electromyography and conduction velocities were calculated by both routine method and interpolation technique.Statistical Analysis Used:Chi-square and Student's t-test were used for comparing group differences. Cut-off points were calculated using receiver operating characteristic curve.Results:A sensitivity of 88%, specificity of 67%, positive predictive value (PPV) and negative predictive value (NPV) of 70.8% and 84.7% were obtained for median motor NCV and a sensitivity of 98.3%, specificity of 91.7%, PPV and NPV of 91.9% and 98.2% were obtained for median sensory NCV with interpolation technique.Conclusions:Median motor interpolation method is a good technique, but it has less sensitivity and specificity than median sensory interpolation method.

Carpal tunnel syndrome and steel industry

The carpal tunnel syndrome (CTS) is a common working pathology. The CTS diagnosis is not so easy because neurophysiological investigations are necessary. The purpose of this study is to evaluate the working risks and the presence of CTS signs using a focused anamnestic and clinical procedure. We evaluated the working risks of CTS in a population of 65 male workers of a steel industry (average age 25.1 and seniority 2.82), performing 5 different tasks. The Borg Scale was used to evaluate the subjective muscle effort. Diurnal paresthesia (V1FG), nocturnal paresthesia (V1FN), hypersensitivity (V1IS), hypostenia (V1IT) were considered. We identified three main working risks repetitiveness of single actions, static and prolonged posture of the truck, muscle effort. 21.5% of the workers showed at least one of the three symptoms;13.8% showed one or more symptoms; the clinical objectivity was observed in 18.5%. A relation between V1FG, V1FN, clinical objective linked to the workers age of the task 1 (p =0.035) is showed. To prevent CTS, the use of the Borg Scale associated with identification of the risks and with the anamenstic-clinical investigation is useful to discriminate people at risk of CTS.

A manual therapy intervention improves symptoms in patients with carpal tunnel syndrome: a pilot study

In carpal tunnel syndrome (CTS), manual therapy interventions (MTI) reduce tissue adhesion and increase wrist mobility. We evaluated the efficacy of a MTI in relieving CTS signs and symptoms. Twenty-two CTS patients (pts) (41 hands) were treated with a MTI, consisting in 6 treatments (2/week for 3 weeks) of soft tissues of wrist and hands and of carpal bones. Pts were assessed for hand sensitivity, paresthesia, hand strength, hand and forearm pain, night awakening; Phalen test, thenar eminence hypotrophy and Boston Carpal Tunnel Questionnaire (BCTQ) Symptom Severity Scale (SSS) and Functional Status Scale (FSS). Median nerve was studied by sensory nerve conduction velocity (SNCV) and distal motor latency (DML). CTS was scored as minimal, mild, medium, severe and extreme. We considered as control group the same pts assessed before treatment: at baseline (T0a) and after 12 weeks (T0b). Pts were evaluated at the end of treatment (T1) and after 24-week (T2) follow-up. At T0b, versus T0a, forearm pain and Phalen test positivity were increased and hand strength reduced (p < 0.05). BCTQ-SSS and BCTQ-FSS scores improved at T1 versus T0b (p < 0.05) with the amelioration maintained at T2. At T1, the number of pts with paresthesia, night awakening, hypoesthesia, Phalen test, hand strength reduction and hand sensitivity was reduced with the lacking of symptoms maintained at T2 (p < 0.05). No changes in SNCV, DML and CTS scoring were shown. MTI improved CTS signs and symptoms, with benefits maintained at follow-up. Thus, it may be valid as a conservative therapy.