Treatment Of Carpal Tunnel Syndrome Research Articles

Comparative Study between Platelet-Rich Plasma, Corticosteroids and Perineural Dextrose local Injections for Treatment of Carpal Tunnel Syndrome

Abstract Background Carpal tunnel syndrome (CTS), one of the most common entrapment neuropathies, is considered as a socio- economic issue that reduces work productivity and increases disability. Aim of the Work to compare the effect of Platelet- Rich Plasma (PRP), corticosteroids (CS) and perineural Dextrose 5 % in water (D5W) local injections for the treatment of idiopathic mild and moderate CTS. Patients and Methods A prospective study was performed on 60 median nerves of 60 patients. They were diagnosed as idiopathic CTS and classified randomly into 3 groups (each contains 20 patients) according to the treatment program received: group I (ultrasound guided CS injection), group II (ultrasound guided perineural Dextrose 5% injection) and group III (ultrasound guided PRP injection). Results Ultrasound guided local injection using single doses of CS, D5W, and PRP were very efficient as regards symptomatic and functional improvement, reducing distal motor latency (DML) and Peak sensory latency ( PSL) of median nerve, as well as decreased Cross Section Area (CSA) of Median nerve (MN) and improving median nerve mobility for idiopathic mild to moderate CTS. For symptom and functional improvement, single injection of CS was more effective than that of PRP and D5W within 3 months post-injection. Moreover, PRP was slightly better than D5W. For reducing DML and PSL, CS was the most effective followed by PRP and then D5W at 3 months post injection. For reducing CSA, CS was the most effective followed by PRP and then D5W at 3 months post injection. For improving mobility of median nerve, D5W was the most effective at 3 months post injection followed by CS and PRP. Conclusion Injection of CS, D5W and PRP had resulted in significant Boston Carpal Tunnel Syndrome Questionnaire (BCTQ) score reduction at 3 months post-injection in comparison to the BCTQ score at the baseline evaluation. All of the three studied groups (Corticosteroids, dextrose 5 % and PRP) have shown a great result regarding improving in clinical examination, clinical assessment scales, nerve conduction studies and improving in Neuromuscular Ultrasound results with favorable results of Corticosteroids group over Perineural dextrose 5 % group and PRP group.

Does Addition of a Longer Acting Local Anesthetic Improve Postoperative Pain After Carpal Tunnel Release? A Randomized Controlled Trial

Carpal tunnel release (CTR) is a simple and effective treatment for carpal tunnel syndrome in patients who have failed nonsurgical management. This surgery is often performed in the ambulatory clinic under local anesthesia, with lidocaine, a short-acting agent. Few studies have investigated the use of longer acting agents, such as bupivacaine, for outpatient CTR. Therefore, the aim of our study was to compare the postoperative pain experience after CTR with the use of either our standard lidocaine solution (control) or a mixture consisting of lidocaine and bupivacaine in equal amounts (intervention). Patients undergoing CTR were randomized into control or intervention groups. Postoperative pain severity and numbness were recorded at several timepoints within the first 72 hours. The timing and quantity of postoperative analgesic use (acetaminophen and/or ibuprofen) was also documented. Both patients and assessor were blinded to allocation. Our study cohort included 139 patients: 67 in the control group and 72 in the intervention group. Postoperative pain scores were significantly lower in the intervention group at 6 hours (2.3 vs 3.2) and 8 hours (2.9 vs 3.9). Additionally, patients in the intervention group reported longer time to first analgesic use than those in the control group (5.2 hours vs 3.7 hours). A greater proportion of patients in the intervention group reported postoperative numbness at nearly all time points, compared to the control group. Our study shows that a mixture of bupivacaine and lidocaine improves early postoperative pain but causes prolonged finger numbness when compared to lidocaine alone. As both medications are effective and feasible for outpatient CTR, surgeon and patient preference should guide local anesthetic choice. Therapeutic Ib.

Registry cost description of carpal tunnel release in Finland in 2011–2015

ObjectivesIn this study, we evaluated the amount of public funds spent on the operative treatment of carpal tunnel syndrome (CTS) in Finland in 2011–2015.DesignA registry-based cost burden study.SettingThe data were...

CLINICAL AND INSTRUMENTAL PREDICTORS OF THE EFFICIENCY OF CONSERVATIVE AND OPERATIVE TREATMENT OF MEDIAN NERVE NEUROPATHY IN THE CARPAL TUNNEL

Introduction. Clinical and instrumental predictors of the efficiency of conservative and surgical treatment of median nerve neuropathy in the carpal tunnel still remain a topical issue. Aim. To identify clinical and instrumental predictors of clinical outcomes and patients’ satisfaction after conservative and surgical treatment of carpal tunnel syndrome. Materials and methods. Analysis of clinical outcomes and patients’ satisfaction in 93 cases with carpal tunnel syndrome: the first group included 49 patients (68 wrists) after conservative and the second group included 44 patients (50 wrists) after surgical treatment. To identify predictors of the efficiency of treatment, analyzed the following clinical-instrumental values: patients’ age, duration of the disease, discriminative sensation, pain intensity according to VAS, values of DASH, BCTQ, CTS scales, clinical stage by Hi-Ob scale, electromyography severity grade according to Bland J.D., nerve conduction study and sonography results. Results. The nerve conduction study and clinical examinations data (discriminative sensation, clinical stage, duration of the disease, BCTQ and DASH values) show reliable effects on clinical outcomes and patients’ satisfaction after conservative treatment. The sensory nerve action potential amplitude and electromyography severity grade have the highest prognostic accuracy (91.4% and 84.5% respectively) for poor (unsatisfactory) result. For surgical treatment, identified results of nerve conduction study, sonography, and patients' age show reliable effects on clinical outcomes and patients’ satisfaction. The values of the highest prognostic accuracy for poor (unsatisfactory) result were nerve deformity index established by sonography (77.8%) and thenar compound muscle action potential amplitude – by nerve conduction study (78.7%). Conclusions. We identified clinical-instrumental predictors of clinical outcomes and patients’ satisfaction after conservative and surgical treatment of carpal tunnel syndrome. Specific results of instrumental examination demonstrated excellent diagnostic quality and the highest prognostic accuracy.

Burden of carpal tunnel syndrome and its associated factors among construction industry workers in Gondar town, Ethiopia.

Carpal tunnel syndrome is characterized by symptoms such as pain, numbness, or tingling on the anterior surface of the index, middle, or radial half of the ring finger, which is frequently associated with weakness of hand grip, and nocturnal pain and/or numbness resulting from compression of the median nerve at the carpal tunnel between the carpal bones and the transverse ligament. The construction industry involves many activities aside from the building process, such as landscaping, painting, electrical supply, plastering, paving, and telecommunications. Performing such tasks involves repetition of wrist flexion and extension, forceful grip with the hand, and/or vibrations of the hand and arm. This study aimed to assess the prevalence of carpal tunnel syndrome and its associated risk factors among construction workers. An institutional-based cross-sectional study design was conducted among six construction sectors in Gondar from April to July 2021. An interviewer-administered questionnaire was prepared from the literature with a Katz hand diagram, and a physical examination and a special test (carpal compression test, Phalen's, and Tinel's test) were carried out for those participants who reported pain during the interview. Binary logistic regression was conducted with SPSS 25 to identify the associated risk factors for carpal tunnel syndrome. The strength of the association was detected by the adjusted odds ratio. A total of 333 study participants aged 18-70 years were included in this study. Among the participants, 11.7% (AOR: 95%CI: 8.1-15.3) had carpal tunnel syndrome. Age, cigarette smoking, work experience, and working with finger-pressing tools were risk factors significantly associated with carpal tunnel syndrome among construction workers with a p-value of <0.05. The magnitude of carpal tunnel syndrome was 11.7% among construction workers. Being of older age, having more experience, cigarette smoking, and working with finger-pressing tools were risk factors significantly associated with carpal tunnel syndrome among construction workers. Employers should implement work safety education programs that raise awareness about the risks of cigarette smoking and encourage employers and supervisors to seek early medical intervention and treatment for carpal tunnel syndrome before it becomes a chronic problem.

Сurrent medical rehabilitation methods for patients after carpal tunnel syndrome surgical treatment: a review

INTRODUCTION. Carpal tunnel syndrome is one of the most common tunnel syndromes types and ranks sixth in the all-occupational diseases’ registry. The high interest in this pathology and its’ postoperative management peculiarities study is due to the disease widespread prevalence, social significance, often unsatisfactory surgical treatment results and a long hand function restoration period. The purpose of this work was to study modern concepts of postoperative rehabilitation of patients with carpal tunnel syndrome. SOURCE SEARCH METHODOLOGY. When preparing the review, open electronic databases of scientific literature were used: PubMed, ClinicalTrials.gov, eLibrary.ru. The search for medical literature data was carried out using the following keywords: “rehabilitation”, “carpal tunnel syndrome”, “carpal tunnel syndrome”, “median nerve”, “compressive neuropathy”. The criteria for inclusion in the analysis of literature sources were: randomized controlled clinical trials, systematic reviews and meta-analyses. Preference was given to publications over the past 5–10 years. DISCUSSION. The article presents the most commonly used techniques in the postoperative management of patients with carpal tunnel syndrome, discusses the mechanisms of their action and prospects for the development of this area. The review discussed the following rehabilitation methods: a wide range of methods of hardware physiotherapy, manual therapy, kinesiotaping, manual lymphatic drainage, as well as the possibilities of physical therapy and robotic mechanotherapy. Despite the high level of development of medicine, the long process of rehabilitation of these patients remains an important problem, while the clinical effectiveness of a wider range of proposed techniques still remains poorly understood. Some of the most promising methods of rehabilitation of patients after surgical treatment for carpal tunnel syndrome are methods of robotic mechanotherapy and extracorporeal shock wave therapy. CONCLUSION. For the effective use of the described techniques as part of the postoperative rehabilitation of patients with carpal tunnel syndrome in clinical practice, further research and study of their long-term effects, as well as comparison of their effectiveness with the aim of the most complete and rapid restoration of the function of the affected hand, is necessary.

Comparing endoscopic and conventional surgery techniques for carpal tunnel syndrome: A retrospective study

IntroductionThis study aimed to compare the effectiveness of endoscopic carpal tunnel release (ECTR) versus open carpal tunnel release (OCTR) in treating carpal tunnel syndrome (CTS), focusing on symptom relief, functional recovery and post-operative complications. MethodsA retrospective analysis was conducted on 44 patients diagnosed with CTS, randomly assigned to undergo either ECTR (n=23) or OCTR (n=21). Parameters evaluated included post-operative pain, grip strength, functional status using the Disability of the Arm, Shoulder and Hand (DASH) score and time to return to work. ResultsPatients who underwent ECTR demonstrated superior functional recovery and quicker return to daily and work activities compared to those in the OCTR group. Grip strength improvement post-surgery showed no significant difference between the groups. However, ECTR patients reported significantly lower DASH scores and faster return to work, indicating better outcomes. There were fewer reports of post-operative complications and scar sensitivity in the ECTR group. ConclusionECTR provides an effective alternative to OCTR for CTS treatment, with advantages in functional recovery speed, reduced post-operative discomfort and faster return to work. These findings support the adoption of ECTR as a preferred surgical approach for CTS, highlighting its potential to improve patient outcomes with minimal complications.

Three in one - unusual palmaris longus muscle anatomical variation.

The palmaris longus muscle (PLM) is one of the most variable muscles in human body, pre-senting a wide range of morphological variants such as reversed course, biventer muscle, bi-furcated tendon or total agenesis. Their clinical impact is particularly important in diagnosis and treatment of carpal tunnel syndrome and reconstructive surgery. We present a case of PLM including a previously undescribed combination of variations. A routine dissection of male cadaver aged approximately 60 demonstrated a biventer muscle, with superior and inferior belly being interrupted by a long tendon. The inferior belly passed deep to the flexor retinaculum and its terminal tendon connected to flexor digitorum superfi-cialis tendon for 5th finger. The clinical importance of variations found have been described separately, including unsuita-bility of biventer muscles for tendon reconstruction and increased risk for developing carpal tunnel syndrome in patients with PLM tendon passing deep to the flexor retinaculum. In conclusion, as another variation of PLM is described, it is crucial to bear in mind the poten-tial morphological types of the muscle in diagnosis and treatment of patients, especially in surgery of the hand and forearm.

Comparison of surgical and non-surgical approaches in the treatment of carpal tunnel syndrome: A Cochrane Review summary with commentary.

Comparison of surgical and non-surgical approaches in the treatment of carpal tunnel syndrome: A Cochrane Review summary with commentary.

Factors Associated with Upper Extremity Functionality After Mini-Open Release Surgery for Treatment of Carpal Tunnel Syndrome

Aim: The objective of this study was to investigate the correlation between upper extremity functionality, pain intensity, muscle strength, and symptom severity among patients diagnosed with carpal tunnel syndrome (CTS) who underwent mini-open release surgery. Material and Method: This retrospective study entailed the review of medical records of 70 patients diagnosed with CTS who underwent mini-open release surgery between January 2021 and January 2023. Data were collected from preoperative assessments and routine follow-up evaluations conducted at 3 months post-surgery. Upper extremity functionality was assessed utilizing the Disabilities of Arm, Shoulder, and Hand (DASH) questionnaire, pain severity was determined using the Visual Analog Scale (VAS), muscle strength was evaluated through hand grip strength, and disease severity was measured using the Boston Carpal Tunnel Questionnaire (BCTQ). Results: A statistically significant improvement was observed in DASH questionnaire scores, VAS scores, hand grip strength, and BCTQ scores at the 3-month follow-up compared to preoperative values (p

D76. Endoscopic Versus Open Treatment of Carpal Tunnel Syndrome: Postoperative Complications in Patients with Diabetes Mellitus

D76. Endoscopic Versus Open Treatment of Carpal Tunnel Syndrome: Postoperative Complications in Patients with Diabetes Mellitus

Post-traumatic carpal tunnel syndrome in children

BackgroundGiven limited information about acute carpal tunnel syndrome (CTS) in children, the purpose of this study is to describe the presentation and treatment results of CTS after traumatic wrist or forearm injury in a pediatric population. MethodsIn this retrospective single-center cohort study, all children with post-traumatic CTS were identified. Demographic and clinical presentation, treatment, and outcomes data were collected from the electronic medical record. Descriptive statistics were calculated for variables of interest, and Χ2 and independent sample t-tests were used for subgroup comparisons. Results18 patients (16 male, average age 12.8 ± 3.6 years) with post-traumatic CTS were identified. 13 presented acutely (<3 days) versus 4 subacutely (1–6 weeks) and one delayed presentation (>6 weeks) after injury. Of associated traumas, 83% (15/18) involved distal radius fractures, of which 40% (6/15) had an associated ulna fracture. The most common symptoms were numbness (78%), paresthesias (33%), and increasing pain (28%). Three patients had clinical concerns for concomitant compartment syndrome. 6 patients were initially monitored (2 acute, 3 subacute, 1 delayed). Ultimately, 16/18 underwent operative release (13/13 acute, 2/4 subacute, 1/1 delayed). At follow-up, 81% of the surgically treated patients had complete symptomatic relief. There was no statistically significant difference in treatment outcomes between acute versus subacute or delayed presentation (OR: 6.67, p = .214). Of patients with acute CTS, delayed surgery resulted in prolonged recovery (28.0 vs. 2.4 weeks, p < .001). ConclusionsPost-traumatic CTS more often presents acutely than as a delayed complication of distal radius fractures in children. The type of injury and clinical presentation can vary, but patients most often present with median neuropathy symptoms like numbness. Acute CTS should be treated urgently with carpal tunnel release. While patients with delayed presentation can trial observation, the patient will likely warrant surgery for complete symptom relief. Operative treatment for both acute and subacute cases generally results in positive outcomes. Key Concepts(1)Post-traumatic CTS may present acutely as a complication of distal radius fractures in children with symptoms of numbness, paresthesias, and increasing pain.(2)Acute CTS should be treated with urgent carpal tunnel release to avoid prolonged recovery.(3)Children with delayed presentation of CTS can be safely monitored, but the patient often needs surgery to experience complete symptom relief.(4)Operative treatment for post-traumatic CTS in children generally results in positive outcomes. Level of EvidenceIV Case Series

Association of carpal tunnel syndrome risk factors with treatment modality selection focusing on corticosteroid injection and surgery: A nationwide population-based study.

Several studies have revealed the risk factors for carpal tunnel syndrome (CTS). However, no studies have evaluated the influence of these risk factors on the selection of treatment modalities for CTS. This study aimed to determine the influence of CTS risk factors on the selection of CTS treatment modalities with a focus on corticosteroid injection (CI) and surgery. We conducted a retrospective cohort study of patients aged ≥20 years with newly diagnosed CTS in the Korean health insurance review and assessment service between 2010 and 2019. We evaluated the demographic information, the existence of CTS risk factors, and the applied treatment modalities for CTS, including CI and operation. The CTS risk factors include age, sex, diabetes mellitus, osteoarthritis of the hand or wrist, rheumatoid arthritis, hypothyroidism, gout, chronic kidney disease (CKD) on dialysis, antiestrogen or aromatase inhibitor medication, and a history of distal radius fracture (DRF). Multivariable logistic regression analyses were conducted. Age over 80 years was the most significantly associated factor for the selection of CI in CTS (odd ratio [OR], 2.149; 95% confidence interval [CI], 2.092 to 2.209; P < .001). Among underlying diseases or medications, CKD on dialysis (OR, 4.001; 95% CI, 3.819-4.193; P < .001) was the most significant associated factor for the selection of operation for CTS, followed by a history of DRF (OR, 1.803; 95% CI, 1.749-1.860; P < .001). Old age was the most significantly related factor for selecting CI. Among underlying diseases or medications, CKD on dialysis and the history of DRF were the most significantly related factors for selecting operative treatment. For these patients, clinicians should proactively consider an operation to reduce the long-term discomfort and economic burdens.

Prospective evaluation of a novel device for ultrasound-guided percutaneous treatment of carpal tunnel and trigger finger disease. Efficacy and safety of sono-instruments®.

To evaluate the safety and effectiveness of percutaneous release procedures under sonography using Sono-Instruments® in the treatment of carpal tunnel syndrome (CTS) and trigger finger (TF). Prospective study involving 30 patients, divided into two groups (15 CTS, and 15 TF). The primary outcomes were surgical performance-related outcomes (visibility, ease of use, satisfaction, duration) using Sono-Instruments® and patient-related outcomes (pain, activity limitations, time to return to work, functional scores). Secondary outcomes included complications. Patients were followed for two months post-operatively. In the CTS group, the average age of the patients was 58.7years. The percutaneous release of the transverse carpal ligament was effectively completed in all cases, with excellent device performance and no adverse events. At one week, all patients could wash their hands, 80% could perform activities of daily living, and 80% of those working had returned to their activities. At two months, all patients had resumed all activities. Pillar pain was still present in 53.3%. In the TF group, the patients had an average age of 57.9years. The percutaneous release of the A1 annular pulley was successful in all cases, with excellent device performance and no adverse events. At one week, all patients could wash their hands, 93.3% could do all activities of daily living, and 75% of those working were back to their professional activities. At two months, all patients were back to all activities of daily living and work. The DASH score was significantly improved at two months, compared to preoperative, for both groups (p < 0.001). Percutaneous sono-guided release using Sono-Instruments® is safe and efficient, and associated with quick functional recovery. II.

Metacarpal Small Incision for Carpal Tunnel Syndrome.

Endoscopic carpal tunnel release (ECTR) techniques have been established as a successful treatment for carpal tunnel syndrome and have proven equally effective as traditional open carpal tunnel release (OCTR) techniques in relieving pain and numbness. However, patients who undergo OCTR are more likely to experience scar tenderness and pillar pain and take longer to return to work. We present here a method of metacarpal small incision for carpal tunnel release (MSICTR) as a safe, reliable, cost-effective alternative surgical decompression of the median nerve of the wrist. This technique utilizes a metacarpal small incision and direct visualization of the median nerve and carpal tunnel contents, reducing the risk of permanent injury and neurasthenia when compared to traditional OCTR. MSICTR is also suitable for the examination of the median nerve, surrounding tendon sheath, or space-occupying lesions. MSICTR is associated with shorter operation times, less postoperative pain, faster recovery, and improved cosmetic results when compared to traditional OCTR. Therefore, MSICTR is an effective surgical decompression of the median nerve for the treatment of carpal tunnel syndrome.

Incidence and Treatment of Carpal Tunnel Syndrome Following Distal Radius Fractures: A TriNetX Analysis of 39,603 Patients

Distal radius fractures (DRFs) are among the most common fractures and occur among all age groups. Carpal tunnel syndrome (CTS) is a known sequela of DRFs, but its incidence is poorly understood. This study was undertaken to determine the incidence of CTS following a DRF, with the hypothesis being that CTS occurs more commonly after nonsurgical treatment of a DRF. The TriNetX US Collaborative Network was queried for all patients diagnosed with DRFs from January 2016 to December 2022. Cohorts were defined by inclusion and exclusion of the procedure Current Procedural Terminology codes into surgical and nonsurgical groups and subsequent ICD-10 diagnosis codes of CTS. Statistical analysis was performed to determine differences in management across the study period. A total of 39,603 patients met inclusion with a diagnosis of a DRF. The incidence of CTS within one year of a DRF was 5.3%. Among all DRF cases, 10,279 (26%) patients underwent surgical treatment, whereas 29,324 (74%) patients underwent nonsurgical treatment. The incidence of CTS in the surgical group was 1194 (12%), whereas the incidence of CTS in the nonsurgical group was 915 (3%). Patients undergoing surgical treatment for a DRF had a 9% risk of developing CTS, whereas patients undergoing nonsurgical treatment had a 5% risk. Among all the patients having been diagnosed with CTS, 63% of those with an operatively treated DRF underwent surgical release, whereas 23% of those with a nonoperatively treated DRF underwent surgical release for CTS. Patients having undergone surgical treatment for DRF had a four times higher rate of developing CTS, compared with those having undergone nonsurgical treatment. Among patients who underwent surgical treatment of a DRF with the subsequent development of CTS, there was a nearly three times higher rate of surgical release of CTS. Prognostic III.

Study on therapeutic management of carpal tunnel syndrome

Carpal tunnel syndrome has long been considered a pathology requiring surgical intervention. Over the years, therapeutic management has become increasingly complex, with improvements observed in patients benefiting from orthopedic, surgical, ergotherapeutic and physiotherapeutic treatments, tailored to individual possibilities. The objective of this case study is to observe whether individualized and adapted kinetic treatment based on specific, non-specific and comprehensive means, succeeds in optimizing the results within the QuickDASH-Score for a 64-year-old patient following surgical intervention for carpal tunnel syndrome. The QuickDASH analyses physical function, pain and other symptoms associated with various types of upper limb musculoskeletal pathologies and disorders. The initial evaluation score was 47 points, with the physiotherapy program carried out over a six-months period. The main objectives included pain, edema, and inflammation control; enhancing joint range of motion within physiological limits in affected areas; preventing muscle-tendon retractions; and fostering independence in daily activities. The final evaluation had 32 points, signifying a 15-point improvement and achievement of the objective, resulting in enhanced quality of life. Physiotherapy in carpal tunnel syndrome is a meticulously applied treatment that alleviates specific symptoms. It's crucial to educate patients on how physiotherapy contributes to full functional recovery, as premature ending can have significant adverse effects on quality of life.

Response to Khan et al: Long-Term Outcomes of Non-surgical versus Surgical Treatment for Carpal Tunnel Syndrome: An Observational Cohort Study.

The letter to the editor discusses the comparative fairness between surgical and non-surgical treatments for Carpal Tunnel Syndrome (CTS), highlighted in Khan et al.'s study. The authors argue that surgical treatments, being based on a unified pathophysiology of decompression, are not comparable to the diverse non-surgical treatments like splinting and local corticosteroid injections, which only some have substantial evidence backing their effectiveness. They reference their own study showing equal effectiveness of surgery and corticosteroid injections in the short term, but a long-term advantage for surgery, despite a significant number of non-surgical cases not requiring further treatment.

EXPLORING THE POSSIBILITIES OF SOME CONTEMPORARY PHYSICAL THERAPY METHODS FOR THE CONSERVATIVE TREATMENT OF CARPAL TUNNEL SYNDROME

Carpal tunnel syndrome (CTS) is the most common compression neuropathy, affecting nearly 5% of the general population. The modern approach to its treatment is complex and includes early diagnosis, prevention and treatment of all conditions and diseases leading to its manifestation.&#x0D; Many authors have worked on the problems related to the possibilities of physical therapy in treating CTS, but the question of optimal treatment and rehabilitation remains relevant to this day. In practice, various rehabilitation programs are constantly being implemented and developed. Many have demonstrated positive outcomes, but work in this area persists. Every novel approach or integration of established physiotherapeutic and rehabilitation techniques enhances the current methods and expands the potential for more comprehensive functional recovery of the impaired limb, as well as the patient's restoration to their previous lifestyle.&#x0D; Physical therapy has advanced significantly in recent decades due to the introduction of numerous new techniques and technologies. The article offers a brief literature overview of several contemporary physical medicine approaches that can be applied in the conservative treatment of carpal tunnel syndrome based on their physiological and therapeutic effects. Modern physical therapy approaches can be a viable alternative to established physical therapy methods like ultrasound, low-level laser, iontophoresis, magnetotherapy, TENS, and others. It is crucial to conduct additional qualitative and comprehensive investigations to verify the effectiveness of physical therapy in treating CTS, identify the most efficient ways, and create improved protocols for its conservative treatment.

Surgical Interventions for the Management of Carpal Tunnel Syndrome: A Narrative Review.

Carpal tunnel syndrome (CTS) is a severe condition that affects the hand, causing pain, numbness, paresthesia, and autonomic dysfunction caused by increased pressure, damage, and demyelination of the median nerve in the carpal tunnel. The most effective treatment for CTS is carpal tunnel release (CTR) via transverse carpal ligament (TCL) transect. We can apply decompression through endoscopic procedures; standard open techniques and minimally invasive wrist incisions can all be used to accomplish decompression. Superior outcomes have been reported in many studies, including patient satisfaction, symptom relief, improvements in multiple assessment modality results, and fewer complications. Soreness at the incision site, tenderness around the site of ligament release, transitory loss of motor or sensory function, and the need for a repeat operation are all postoperative consequences. There is minimal and low-quality evidence to support the effectiveness of postoperative rehabilitation, such as wrist orthoses, dressings, exercise, and ice therapy, which have benefited patients anecdotally.