Current options for nonsurgical management of carpal tunnel syndrome

International Journal of Clinical Rheumatology

Volumn 5, Issue 1, 2010, Pages 129-142

  Carlson, Hans ^a   Colbert, Agatha ^a   Frydl, Jennifer ^a   Arnall, Elizabeth ^a   Elliott, Molly ^a   Carlson, Nels ^a  

^a OREGON HEALTH AND SCIENCE UNIVERSITY   (United States)

Author keywords

Alternative therapy; Braces; Carpal tunnel syndrome; Conservative treatment; Corticosteroid injection; Exercise; Treatment outcome

Indexed keywords

BETAMETHASONE; CORTICOSTEROID; IBUPROFEN; LIDOCAINE; METHYLPREDNISOLONE; NONSTEROID ANTIINFLAMMATORY AGENT; PLACEBO; TRIAMCINOLONE;

ACUPUNCTURE; ALTERNATIVE MEDICINE; BRACE; CARPAL TUNNEL SYNDROME; CLINICAL TRIAL; CONSERVATIVE TREATMENT; DISEASE COURSE; DISEASE SEVERITY; ELECTRODIAGNOSIS; ELECTROPHYSIOLOGY; HUMAN; IMMOBILIZATION; IONTOPHORESIS; KINESIOTHERAPY; LOW LEVEL LASER THERAPY; MAGNETOTHERAPY; NERVE DECOMPRESSION; OCCUPATIONAL THERAPY; OUTCOME ASSESSMENT; PHYSIOTHERAPY; PRIORITY JOURNAL; REVIEW; SPLINTING; THERAPY EFFECT; TRACTION THERAPY; TREATMENT INDICATION; ULTRASOUND THERAPY; YOGA;

EID: 77950284300     PISSN: 17584272     EISSN: None     Source Type: Journal    
DOI: 10.2217/ijr.09.63     Document Type: Review

References (84)

1. Papanicolaou GD, McCabe SJ, Firrell J: The prevalence and characteristics of nerve compression symptoms in the general population. J. Hand Surg. Am. 26, 460-466 (2001).
2. Aroori S, Spence RA: Carpal tunnel syndrome. Ulster Med. J. 77, 6-17 (2008).
3. Practice parameter for carpal tunnel syndrome (summary statement). Report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology 43, 2406-2409 (1993).
4. Practice parameter for electrodiagnostic studies in carpal tunnel syndrome (summary statement). American Academy of Neurology, American Association of Electrodiagnostic Medicine, and American Academy of Physical Medicine and Rehabilitation. Neurology 43, 2404-2405 (1993).
5. American Association of Electrodiagnostic Medicine, American Academy of Neurology, American Academy of Physical Medicine and Rehabilitation: Practice parameter for electrodiagnostic studies in carpal tunnel syndrome: summary statement. Muscle Nerve 16, 1390-1391 (1993).
6. American Association of Electrodiagnostic Medicine, American Academy of Neurology, and American Academy of Physical Medicine and Rehabilitation: Practice parameter for electrodiagnostic studies in carpal tunnel syndrome: summary statement. Muscle Nerve 25, 918-922 (2002).
7. Atroshi I, Gummesson C, Johnsson R, Ornstein E, Ranstam J, Rosen I: Prevalence of carpal tunnel syndrome in a general population. JAMA 282, 153-158 (1999).
8. Atroshi I, Gummesson C, Johnsson R, McCabe SJ, Ornstein E: Severe carpal tunnel syndrome potentially needing surgical treatment in a general population. J. Hand Surg. Am. 28, 639-644 (2003).
9. de Krom MC, Knipschild PG, Kester AD, Thijs CT, Boekkooi PF, Spaans F: Carpal tunnel syndrome: prevalence in the general population. J. Clin. Epidemiol. 45, 373-376 (1992).
10. Bongers FJ, Schellevis FG, van den Bosch WJ, van der Zee J: Carpal tunnel syndrome in general practice (1987 and 2001): incidence and the role of occupational and non-occupational factors. Br. J. Gen. Pract. 57, 36-39 (2007).
11. Karsidag S, Sahin S, Hacikerim Karsidag S, Ayalp S: Long term and frequent electrophysiological observation in carpal tunnel syndrome. Eura. Medicophys. 43, 327-332 (2007).
12. Mattioli S, Baldasseroni A, Curti S et al.: Incidence rates of surgically treated idiopathic carpal tunnel syndrome in blue- and white-collar workers and housewives in Tuscany, Italy. Occup. Environ. Med. 66, 299-304 (2009).
13. Armstrong T, Dale AM, Franzblau A, Evanoff BA: Risk factors for carpal tunnel syndrome and median neuropathy in a working population. J. Occup. Environ. Med. 50, 1355-1364 (2008).
14. Palmer KT, Harris EC, Coggon D: Carpal tunnel syndrome and its relation to occupation: a systematic literature review. Occup. Med. (Lond.) 57, 57-66 (2007).
15. Thomsen JF, Gerr F, Atroshi I: Carpal tunnel syndrome and the use of computer mouse and keyboard: a systematic review. BMC Musculoskelet. Disord. 9, 134 (2008).
16. Franzblau A, Werner RA: What is carpal tunnel syndrome? JAMA 282, 186-187 (1999).
17. Verdugo RJ, Salinas RA, Castillo JL, Cea JG: Surgical versus non-surgical treatment for carpal tunnel syndrome. [update of Cochrane Database Syst. Rev. 2003; (3), CD001552; PMID: 12917909]. Cochrane Database Syst.Rev. (4), CD001552 (2008).
18. Resende LA, Tahara A, Fonseca RG, Sardenberg T: The natural history of carpal tunnel syndrome. A study of 20 hands evaluated 4 to 9 years after initial diagnosis. Electromyogr. Clin. Neurophysiol. 43, 301-304 (2003).
19. Padua L, Padua R, Aprile I et al.: Multiperspective follow-up of untreated carpal tunnel syndrome: a multicenter study. Neurology 56, 1459-1466 (2001).
20. Hardoim DG, de Oliveira GB, Kouyoumdjian JA: Carpal tunnel syndrome: long-term nerve conduction studies in 261 hands. Arq. Neuropsiquiatr. 67, 69-73 (2009).
21. Muhlau G, Both R, Kunath H: Carpal tunnel syndrome - course and prognosis. J. Neurol. 231, 83-86 (1984).
22. Ortiz-Corredor F, Enriquez F, Diaz-Ruiz J, Calambas N: Natural evolution of carpal tunnel syndrome in untreated patients. Clin. Neurophysiol. 119, 1373-1378 (2008).
23. Maghsoudipour M, Moghimi S, Dehghaan F, Rahimpanah A: Association of occupational and non-occupational risk factors with the prevalence of work related carpal tunnel syndrome. J. Occup. Rehabil. 18, 152-156 (2008).
24. McCabe SJ, Uebele AL, Pihur V, Rosales RS, Atroshi I: Epidemiologic associations of carpal tunnel syndrome and sleep position: is there a case for causation? Hand (NY) 2, 127-134 (2007).
25. Gupta R, Rummler L, Steward O: Understanding the biology of compressive neuropathies. Clin. Orthop. Relat. Res. (436), 251-260 (2005).
26. Gelberman RH, Hergenroeder PT, Hargens AR, Lundborg GN, Akeson WH: The carpal tunnel syndrome. A study of carpal canal pressures. J. Bone Joint Surg. Am. 63, 380-383 (1981).
27. Weiss ND, Gordon L, Bloom T, So Y, Rempel DM: Position of the wrist associated with the lowest carpal-tunnel pressure: implications for splint design. J. Bone Joint Surg. Am. 77, 1695-1699 (1995).
28. Cobb TK, An KN, Cooney WP: Effect of lumbrical muscle incursion within the carpal tunnel on carpal tunnel pressure: a cadaveric study. J. Hand Surg. Am. 20, 186-192 (1995).
29. Cobb TK, An KN, Cooney WP, Berger RA: Lumbrical muscle incursion into the carpal tunnel during finger flexion. J. Hand Surg. Br. 19, 434-438 (1994).
30. Manente G, Torrieri F, Di Blasio F, Staniscia T, Romano F, Uncini A: An innovative hand brace for carpal tunnel syndrome: a randomized controlled trial. Muscle Nerve 24, 1020-1025 (2001).
31. De Angelis MV, Pierfelice F, Di Giovanni P, Staniscia T, Uncini A: Efficacy of a soft hand brace and a wrist splint for carpal tunnel syndrome: a randomized controlled study. Acta Neurol. Scand. 119, 68-74 (2009).
32. Gerritsen AA, de Vet HC, Scholten RJ, Bertelsmann FW, de Krom MC, Bouter LM: Splinting vs surgery in the treatment of carpal tunnel syndrome: a randomized controlled trial. JAMA 288, 1245-1251 (2002).
33. Brininger TL, Rogers JC, Holm MB, Baker NA, Li ZM, Goitz RJ: Efficacy of a fabricated customized splint and tendon and nerve gliding exercises for the treatment of carpal tunnel syndrome: a randomized controlled trial. Arch. Phys. Med. Rehabil. 88, 1429-1435 (2007).
34. O'Connor D, Marshall SC, Massy-Westropp N: Non-surgical treatment (other than steroid injection) for carpal tunnel syndrome. Cochrane Database Syst. Rev. (1), CD003219 (2003).
35. Piazzini DB, Aprile I, Ferrara PE et al.: A systematic review of conservative treatment of carpal tunnel syndrome. Clin. Rehabil. 21, 299-314 (2007).
36. Korthals-de Bos IB, Gerritsen AA, van Tulder MW et al.: Surgery is more cost-effective than splinting for carpal tunnel syndrome in The Netherlands: results of an economic evaluation alongside a randomized controlled trial. BMC Musculoskelet. Disord. 7, 86 (2006).
37. Gerritsen AA, de Vet HC, Scholten RJ, van Tulder MW, Bouter LM: Enabling meta-analysis in systematic reviews on carpal tunnel syndrome. J. Hand Surg. Am. 27, 828-832 (2002).
38. Gerritsen AA, de Krom MC, Struijs MA, Scholten RJ, de Vet HC, Bouter LM: Conservative treatment options for carpal tunnel syndrome: a systematic review of randomised controlled trials. J. Neurol. 249, 272-280 (2002).
39. Armstrong T, Devor W, Borschel L, Contreras R: Intracarpal steroid injection is safe and effective for short-term management of carpal tunnel syndrome. Muscle Nerve 29, 82-88 (2004).
40. Phalen GS: The carpal-tunnel syndrome. Clinical evaluation of 598 hands. Clin. Orthop. 83, 29-40 (1972).
41. Phalen GS: The carpal-tunnel syndrome. Seventeen years' experience in diagnosis and treatment of six hundred fifty-four hands. J. Bone Joint Surg. Am. 48, 211-228 (1966).
42. Boyer MI: Corticosteroid injection for carpal tunnel syndrome. J. Hand Surg. Am. 33, 1414-1416 (2008).
43. Gurcay E, Unlu E, Gurcay AG, Tuncay R, Cakci A: Evaluation of the effect of local corticosteroid injection and anti-inflammatory medication in carpal tunnel syndrome. Scott. Med. J. 54, 4-6 (2009).
44. Lee JH, An JH, Lee SH, Hwang EY: Effectiveness of steroid injection in treating patients with moderate and severe degree of carpal tunnel syndrome measured by clinical and electrodiagnostic assessment. Clin. J. Pain 25, 111-115 (2009).
45. Frederick HA, Carter PR, Littler JW: Injection injuries to the median and ulnar nerves at the wrist. J. Hand Surg. Am. 17, 645-647 (1992).
46. Kasten SJ, Louis DS: Carpal tunnel syndrome: a case of median nerve injection injury and a safe and effective method for injecting the carpal tunnel. J. Fam. Pract. 43, 79-82 (1996).
47. Linskey ME, Segal R: Median nerve injury from local steroid injection in carpal tunnel syndrome. Neurosurgery 26, 512-515 (1990).
48. McConnell JR, Bush DC: Intraneural steroid injection as a complication in the management of carpal tunnel syndrome. A report of three cases. Clin. Orthop. Relat. Res. (250), 181-184 (1990).
49. Tavares SP, Giddins GE: Nerve injury following steroid injection for carpal tunnel syndrome. A report of two cases. J. Hand Surg. Br. 21, 208-209 (1996).
50. Wilbourn AJ: Iatrogenic nerve injuries. Neurol. Clin. 16, 55-82 (1998).
51. Muller M, Tsui D, Schnurr R, Biddulph-Deisroth L, Hard J, MacDermid JC: Effectiveness of hand therapy interventions in primary management of carpal tunnel syndrome: a systematic review. J. Hand Ther. 17, 210-228 (2004).
52. Banta CA: A prospective, nonrandomized study of iontophoresis, wrist splinting, and antiinflammatory medication in the treatment of early-mild carpal tunnel syndrome. J. Occup. Med. 36, 166-168 (1994).
53. Gokoglu F, Fndkoglu G, Yorgancoglu ZR, Okumus M, Ceceli E, Kocaoglu S: Evaluation of iontophoresis and local corticosteroid injection in the treatment of carpal tunnel syndrome. Am. J. Phys. Med. Rehabil. 84, 92-96 (2005).
54. Osterman AL, Whitman M, Porta LD: Nonoperative carpal tunnel syndrome treatment. Hand Clin. 18, 279-289 (2002).
55. Ebenbichler GR, Resch KL, Nicolakis P et al.: Ultrasound treatment for treating the carpal tunnel syndrome: randomised "sham" controlled trial. BMJ 316, 731-735 (1998).
56. Oztas O, Turan B, Bora I, Karakaya MK: Ultrasound therapy effect in carpal tunnel syndrome. Arch. Phys. Med. Rehabil. 79, 1540-1544 (1998).
57. Butler D, Gifford L: The concept of adverse mechanical tension in the nervous system, part 2; examination and treatment. Physiotherapy 75, 629-636 (1989).
58. Rempel D, Manojlovic R, Levinsohn DG, Bloom T, Gordon L: The effect of wearing a flexible wrist splint on carpal tunnel pressure during repetitive hand activity. J. Hand Surg. Am. 19, 106-110 (1994).
59. Heebner ML, Roddey TS: The effects of neural mobilization in addition to standard care in persons with carpal tunnel syndrome from a community hospital. J. Hand Ther. 21, 229-240 (2008).
60. Akalin E, El O, Peker O et al.: Treatment of carpal tunnel syndrome with nerve and tendon gliding exercises. Am. J. Phys. Med. Rehabil. 81, 108-113 (2002).
61. Tal-Akabi A, Rushton A: An investigation to compare the effectiveness of carpal bone mobilisation and neurodynamic mobilisation as methods of treatment for carpal tunnel syndrome. Manual Ther. 5, 214-222 (2000).
62. Porrata H, Porrata A, Sosner J: New carpal ligament traction device for the treatment of carpal tunnel syndrome unresponsive to conservative therapy. J. Hand Ther. 20, 20-27 (2007).
63. Barnes PM, Bloom B, Nahin RL: Complementary and alternative medicine use among adults and children: United States, 2007. Natl Health Stat. Report 10(12), 1-23 (2008).
64. NIH Consensus Conference. Acupuncture. JAMA 280, 1518-1524 (1998).
65. Yang CP, Hsieh CL, Wang NH et al.: Acupuncture in patients with carpal tunnel syndrome: a randomized controlled trial. Clin. J. Pain 25, 327-333 (2009).
66. Branco K, Naeser MA: Carpal tunnel syndrome: clinical outcome after low-level laser acupuncture, microamps transcutaneous electrical nerve stimulation, and other alternative therapies - an open protocol study. J. Altern. Complement. Med. 5, 5-26 (1999).
67. Naeser MA, Hahn KA, Lieberman BE, Branco KF: Carpal tunnel syndrome pain treated with low-level laser and microamperes transcutaneous electric nerve stimulation: a controlled study. Arch. Phys. Med. Rehabil. 83, 978-988 (2002).
68. Weintraub MI: Noninvasive laser neurolysis in carpal tunnel syndrome. Muscle Nerve 20, 1029-1031 (1997).
69. Elwakil TF, Elazzazi A, Shokeir H: Treatment of carpal tunnel syndrome by low-level laser versus open carpal tunnel release. Lasers Med. Sci. 22, 265-270 (2007).
70. Bakhtiary AH, Rashidy-Pour A: Ultrasound and laser therapy in the treatment of carpal tunnel syndrome. Aust. J. Physiother. 50, 147-151 (2004).
71. Padua L, Padua R, Aprile I, Tonali P: Noninvasive laser neurolysis in carpal tunnel syndrome. Muscle Nerve 21, 1232-1233 (1998).
72. Irvine J, Chong SL, Amirjani N, Chan KM: Double-blind randomized controlled trial of low-level laser therapy in carpal tunnel syndrome. Muscle Nerve 30, 182-187 (2004).
73. Shooshtari SM, Badiee V, Taghizadeh SH, Nematollahi AH, Amanollahi AH, Grami MT: The effects of low level laser in clinical outcome and neurophysiological results of carpal tunnel syndrome. Electromyogr. Clin. Neurophysiol. 48, 229-231 (2008).
74. Chang WD, Wu JH, Jiang JA, Yeh CY, Tsai CT: Carpal tunnel syndrome treated with a diode laser: a controlled treatment of the transverse carpal ligament. Photomed. Laser Surg. 26, 551-557 (2008).
75. Garfinkel MS, Singhal A, Katz WA, Allan DA, Reshetar R, Schumacher HR Jr: Yoga-based intervention for carpal tunnel syndrome: a randomized trial. JAMA 280, 1601-1603 (1998).
76. O'Connor D, Marshall S, Massy-Westropp N: Non-surgical treatment (other than steroid injection) for carpal tunnel syndrome. Cochrane Database Syst. Rev. (1), CD003219 (2003).
77. Carter R, Aspy CB, Mold J: The effectiveness of magnet therapy for treatment of wrist pain attributed to carpal tunnel syndrome. J. Fam. Pract. 51, 38-40 (2002).
78. Weintraub MI, Cole SP: Neuromagnetic treatment of pain in refractory carpal tunnel syndrome: an electrophysiological and placebo analysis. J. Back Musculoskeletal Rehabil. 15, 77 (2000).
79. Weintraub MI, Cole SP: A randomized controlled trial of the effects of a combination of static and dynamic magnetic fields on carpal tunnel syndrome. Pain Med. 9, 493-504 (2008).
80. Evcik D, Kavuncu V, Cakir T, Subasi V, Yaman M: Laser therapy in the treatment of carpal tunnel syndrome: a randomized controlled trial. Photomed.Laser Surg. 25, 34-39 (2007).
81. Ekim A, Armagan O, Tascioglu F, Oner C, Colak M: Effect of low level laser therapy in rheumatoid arthritis patients with carpal tunnel syndrome. Swiss Med. Wkly 137, 347-352 (2007).
82. Yagci I, Elmas O, Akcan E, Ustun I, Gunduz OH, Guven Z: Comparison of splinting and splinting plus low-level laser therapy in idiopathic carpal tunnel syndrome. Clin. Rheumatol. 28, 1059-1065 (2009).
83. Dincer F, Linde K: Sham interventions in randomized clinical trials of acupuncture - a review. Complement Ther. Med. 11, 235-242 (2003).
84. Michalsen A, Bock S, Ludtke R et al.: Effects of traditional cupping therapy in patients with carpal tunnel syndrome: a randomized controlled trial. J. Pain 10, 601-608 (2009).