Evidence reviews
Carpal tunnel syndrome is caused by compression of the median nerve which goes through the carpal tunnel in the wrist. It causes tingling, numbness and pain, mostly in the hand. Treatment is controversial. This review aimed to compare surgical decompression with non‐surgical treatments such as splinting or corticosteroid injections. Four trials were found and included, while three are awaiting assessment. The results suggest that surgical treatment is probably better than splinting but it is unclear whether it is better than steroid injection. Further research is needed for those with mild symptoms.
There is no strong evidence for the replacement of standard open carpal tunnel release (OCTR) by alternative surgical procedures for the treatment of carpal tunnel syndrome. The decision to apply special, minimally invasive operations instead of standard OCTR seems to be guided by the surgeon's and patient's preferences.
Local corticosteroid injection is a common non‐surgical treatment for carpal tunnel syndrome. Other non‐surgical treatments include the use of wrist splints, ultrasound and oral anti‐inflammatory agents. Surgical intervention is also known to be effective. This systematic review confirmed the effectiveness of local corticosteroid injection for relief of symptoms for severe carpal tunnel syndrome up to one month after injection. Local corticosteroid injection provides significantly greater clinical improvement compared to oral corticosteroid up to three months after treatment. Two injections of local corticosteroid do not provide significant further clinical improvement of symptoms. Further research is required to determine length of benefit of local corticosteroid injection and benefit for mild and moderate carpal tunnel syndrome.
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Summaries for consumers
Many people who have carpal tunnel syndrome have mild or moderate symptoms that come and go. In those cases wearing a splint and avoiding too much stress on the joint may be enough to provide relief.The main symptoms of carpal tunnel syndrome are tingling, numbness or pain in parts of the hand. Sometimes it is difficult to move your thumb or first two fingers. This is caused by excess pressure on the median nerve, which runs through the carpal tunnel in the wrist.Sometimes these symptoms disappear again without treatment. A wrist splint can be worn for support. A splint does not always offer enough relief from symptoms, but it has virtually no side effects compared with other treatment options like corticosteroid therapy or surgery.
Treating carpal tunnel syndrome symptoms with corticosteroids can provide temporary relief. Corticosteroid injections are more effective than corticosteroids taken as tablets.Pain, tingling sensations or numbness in your hand may possibly be caused by carpal tunnel syndrome. In carpal tunnel syndrome the median nerve that runs through the carpal tunnel in your wrist and is connected to the ball of the thumb and other parts of the hand is compressed. Injecting corticosteroids is one of the most effective treatments available.Corticosteroids are the synthetic versions of a hormone called cortisol, which is produced naturally in the adrenal glands. Cortisol has an anti-inflammatory effect and acts to reduce swelling. Corticosteroids – synthetic cortisol – can be taken in tablets or injected into the affected tissue. Corticosteroid treatments are usually used for carpal tunnel syndrome when wearing a splint has not made any difference. Injecting corticosteroids is more common and more effective than taking the tablets.
Carpal tunnel syndrome is caused by compression of the median nerve which goes through the carpal tunnel in the wrist. It causes tingling, numbness and pain, mostly in the hand. Treatment is controversial. This review aimed to compare surgical decompression with non‐surgical treatments such as splinting or corticosteroid injections. Four trials were found and included, while three are awaiting assessment. The results suggest that surgical treatment is probably better than splinting but it is unclear whether it is better than steroid injection. Further research is needed for those with mild symptoms.
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