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Evidence summaries

Non-Surgical Treatment for Carpal Tunnel Syndrome

Non-surgical treatments (hand braces, ultrasound, oral medications) may provide short time relief for carpal tunnel syndrome. Level of evidence: "C"

A Cochrane review (abstract , review [Abstract]) included 21 studies with a total of 884 patients. A hand brace significantly improved symptoms after four weeks (WMD -1.07; 95% CI -1.29 to -0.85) and function (WMD -0.55; 95% CI -0.82 to -0.28). One trial showed significant symptom improvement after seven weeks of ultrasound (WMD -0.99; 95% CI -1.77 to - 0.21), which was maintained at six months (WMD -1.86; 95% CI -2.67 to -1.05). Four trials involving 193 people examined various oral medications (steroids, diuretics, nonsteroidal anti-inflammatory drugs) versus placebo. Compared to placebo, pooled data for two-week oral steroid treatment demonstrated a significant improvement in symptoms (WMD -7.23; 95% CI -10.31 to -4.14).

Comment: The quality of evidence is downgraded by inconsistency (heterogeneity in studied interventions and outcomes) and study quality (inadequate or unclear allocation concealment).

    References

    • O'Connor D, Marshall S, Massy-Westropp N. Non-surgical treatment (other than steroid injection) for carpal tunnel syndrome. Cochrane Database Syst Rev 2003;(1):CD003219. [PubMed]

Primary/Secondary Keywords