Carpal Tunnel Syndrome - Splint, Surgery, or Watch-and-Wait?
Wednesday October 8, 2008
The best approach for treating carpal tunnel syndrome has been studied and debated for years. An updated review of studies that appears in Issue 4 (2008) of The Cochrane Library concludes that surgery is more effective at relieving carpal tunnel symptoms than splinting. Compared to non-surgical treatment options, patients were found to have significantly less pain, tingling, numbness, and muscle weakness at 3 months and one year following surgery.
In the updated review, Chilean researchers evaluated 4 new studies that involved 317 patients with carpal tunnel syndrome. Patients who had surgery to treat carpal tunnel syndrome rarely had to return for a second surgery. Patients who were first treated with medication or splinting often had surgery later.
Initially, most carpal tunnel patients are treated non-surgically, although treatment varies worldwide. Researchers concluded that surgery was better than splinting, although it was less clear whether surgery was better than a steroid injection. Some researchers believe a watch-and-wait approach is best since many patients stay the same or improve over time.
Related Resources:
- What Is Carpal Tunnel Syndrome?
- Carpal Tunnel Syndrome Screening Quiz
- Test Your Knowledge: Carpal Tunnel Syndrome
- How Carpal Tunnel Syndrome Develops: Step-By-Step
Share Your Advice and Experiences:
Photo © A.D.A.M.
Comments
Did this study not look at physical or occupational therapy? I developed carpal tunnel syndrome in college, as a result of waiting tables. I wore the splints and had occupational therapy, where I learned several stretching exercises and found different ways to do things at work.
The results were amazing — in just a few weeks I went from being unable to wash my own hair or push buttons on the remote to being quite functional, as long as I kept up with the stretches and wore the splints a lot.
Eventually, I recovered fully and now I only have problems if I really overuse my arms.
The selection criteria for the Cochrane review was stated as “all randomised and quasi-randomised controlled trials comparing any surgical and any non-surgical therapies.” It also said “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.”
Even so — I believe their conclusions are generalizations — and not meant to imply splints, or occupational and physical therapy, help no one. As with any treatment for any condition — the results vary among individual patients. Thanks for sharing your positive experience.