Comparison of Treatment Methods for Carpal Tunnel Syndrome: Surgical vs. Non-Surgical
DOI:
https://doi.org/10.12775/QS.2024.21.54205Keywords
carpal tunnel syndrome, surgical management, surgical repair, minimally invasive surgery, wrist, non-pharmacological interventionsAbstract
Introduction
Carpal tunnel syndrome (CTS) is a common condition that results from the compression of the median nerve within the carpal tunnel in the wrist. Both surgical and non-surgical treatments are used to manage CTS. While surgery is necessary in some cases, many patients can be treated effectively with conservative methods. This review compares the efficacy of surgical treatment for CTS against various conservative approaches.
Aim
The study aims to evaluate and compare the outcomes of surgical versus conservative treatments for CTS, focusing on symptom relief, patient outcomes, and long-term prognosis.
State of Knowledge
The carpal tunnel is a narrow passage in the wrist formed by carpal bones and the flexor retinaculum. Compression of the median nerve within this tunnel leads to CTS, which can be caused by anatomical variations or systemic conditions like diabetes. Symptoms include pain, numbness, and tingling in the hand, which may worsen at night or with repetitive movements.
Summary (Conclusions)
Surgical treatment, especially decompression, offers superior symptom relief and functional improvement but carries risks of complications. Conservative treatments like wrist immobilization and anti-inflammatory medications are effective for many patients, supporting their use as initial treatment. Further research is needed to optimize CTS management.
References
Chammas M, Boretto J, Burmann LM, Ramos RM, Neto FC dos S, Silva JB. Carpal tunnel syndrome – Part I (anatomy, physiology, etiology and diagnosis). Rev Bras Ortop (Sao Paulo) 2014; 49: 429.
Omole AE, Awosika A, Khan A et al. An Integrated Review of Carpal Tunnel Syndrome: New Insights to an Old Problem. Cureus 2023;
Çupi B, Šarac I, Jovanović JJ et al. Occupational and non-occupational risk factors correlating with the severity of clinical manifestations of carpal tunnel syndrome and related work disability among workers who work with a computer. Arh Hig Rada Toksikol 2023; 74: 252–272.
Bicha N, Gashaw M, Chanie ST, Mekie M, Yalew ES. Burden of carpal tunnel syndrome and its associated factors among construction industry workers in Gondar town, Ethiopia. Front Public Health 2024; 12.
Honis HR, Gruber H, Honold S et al. Anatomical considerations of US-guided carpal tunnel release in daily clinical practice. J Ultrason 2023; 23: E131–E143.
Liu Y, Zhuang Y, Wei R, Tan Z, Chen C, Yang D. Comparison of characteristics between neuropathic pain and non-neuropathic pain in patients with diabetic carpal tunnel syndrome: A cross-sectional study. Front Surg 2022; 9.
Ashour AA, Yehia RM, ElMeligie MM, Hanafy AF. Effectiveness of high intensity laser therapy on pain, grip strength and median nerve conductivity in pregnant women with carpal tunnel syndrome: A randomized controlled trial. Journal of Hand Therapy 2023; 36: 536–545.
Demissie B, Yenew C, Alemu A et al. Carpal tunnel syndrome and its associated factors among computer user bankers in South Gondar Zone, Northwest Ethiopia, 2021: a cross sectional study. BMC Musculoskelet Disord 2023; 24.
Tumpaj T, Potocnik Tumpaj V, Albano D, Snoj Z. Ultrasound-guided carpal tunnel injections. Radiol Oncol 2022; 56: 14–22.
Pripotnev S, Mackinnon SE. Revision of Carpal Tunnel Surgery. J Clin Med 2022; 11.
Ng AWH, Griffith JF, Tsoi C et al. Ultrasonography findings of the carpal tunnel after endoscopic carpal tunnel release for carpal tunnel syndrome. Korean J Radiol 2021; 22: 1132–1141.
Scalise V, Brindisino F, Pellicciari L, Minnucci S, Bonetti F. Carpal tunnel syndrome: A national survey to monitor knowledge and operating methods. Int J Environ Res Public Health 2021; 18: 1–27.
Schäfer L, Maffulli N, Baroncini A, Eschweiler J, Hildebrand F, Migliorini F. Local Corticosteroid Injections versus Surgical Carpal Tunnel Release for Carpal Tunnel Syndrome: Systematic Review and Meta-Analysis. Life 2022; 12.
Li Y, Luo W, Wu G, Cui S, Zhang Z, Gu X. Open versus endoscopic carpal tunnel release: A systematic review and meta-analysis of randomized controlled trials. BMC Musculoskelet Disord 2020; 21.
Ku YC, Gannon M, Fang W, Norcini RC, Woodberry KM. Management of Acute Carpal Tunnel Syndrome: A Systematic Review. J Hand Surg Glob Online 2023; 5: 606–611.
Wielemborek PT, Kapica-Topczewska K, Pogorzelski R, Bartoszuk A, Kochanowicz J, Kułakowska A. Carpal tunnel syndrome conservative treatment: A literature review. Postepy Psychiatrii i Neurologii 2022; 31: 85–94.
Yang FA, Wang HY, Kuo TY et al. Injection therapy for carpal tunnel syndrome: A systematic review and network meta-analysis of randomized controlled trials. PLoS One 2024; 19.
Liawrungrueang W, Wongsiri S, Sarasombath P. Endoscopic carpal surgery in carpal tunnel syndrome: A systematic review. SAGE Open Medicine 11 2023.
Wade RG, Wormald JCR, Figus A. Absorbable versus non-absorbable sutures for skin closure after carpal tunnel decompression surgery. Cochrane Database of Systematic Reviews 2018; 2018.
Zhou Q, Shen Y, Zhu X et al. Ultrasound-guided percutaneous release procedures in the transverse carpal ligament by acupotomy: A cadaveric study. Front Surg 2023; 9.
Carmo JD. ‘INSIGHT-PRECISION’: a new, mini-invasive technique for the surgical treatment of carpal tunnel syndrome. Journal of International Medical Research 2020; 48.
Zeng Z, Lin N, Chen CX. Comparison efficacy of ultrasound-guided needle release plus corticosteroid injection and mini-open surgery in patients with carpal tunnel syndrome. Front Neurol 2023; 14.
Fernandes CH, Santos JBG Dos, Schwartz-Fernandes F, Ostermann AL, Faloppa F. Failure factors for carpal tunnel syndrome surgical treatment: When and how to perform a revision carpal tunnel decompression surgery. Rev Bras Ortop (Sao Paulo) 2022; 57: 718–725.
Yoshii Y, Tung WL, Yuine H, Ishii T. Postoperative diagnostic potentials of median nerve strain and applied pressure measurement after carpal tunnel release. BMC Musculoskelet Disord 2020; 21.
Wu YT, Lam KHS, Lai CY et al. Novel Motor-Sparing Ultrasound-Guided Neural Injection in Severe Carpal Tunnel Syndrome: A Comparison of Four Injectates. Biomed Res Int 2022; 2022.
Karjalainen T V., Lusa V, Page MJ, O’Connor D, Massy-Westropp N, Peters SE. Splinting for carpal tunnel syndrome. Cochrane Database of Systematic Reviews 2023; 2023.
Jiménez-del-Barrio S, Ceballos-Laita L, Bueno-Gracia E, Rodríguez-Marco S, Caudevilla-Polo S, Estébanez-de-Miguel E. Diacutaneous Fibrolysis Intervention in Patients with Mild to Moderate Carpal Tunnel Syndrome May Avoid Severe Cases in Elderly: A Randomized Controlled Trial. Int J Environ Res Public Health 2022; 19.
Chen SR, Ho TY, Shen YP et al. Comparison of short-and long-axis nerve hydrodissection for carpal tunnel syndrome: A prospective randomized, single-blind trial. Int J Med Sci 2021; 18: 3488–3497.
Yu L, Jia J, Lakshminarayanan K, Li Y, Gan Y, Yao Y. A finite element analysis of the carpal arch with various locations of carpal tunnel release. Front Surg 2023; 10.
Zheng D, Wu Z, Li L, Chen S, Chang J. Research advances and trends in the surgical treatment of carpal tunnel syndrome from 2003 to 2022: A CiteSpace-based bibliometric analysis. Front Neurol 2023; 14.
Graesser EA, Dy CJ, Brogan DM. Future Considerations in the Diagnosis and Treatment of Compressive Neuropathies of the Upper Extremity. J Hand Surg Glob Online 2023; 5: 536–546.
Lo IN, Hsu PC, Huang YC, Yeh CK, Yang YC, Wang JC. Dynamic Ultrasound Assessment of Median Nerve Mobility Changes Following Corticosteroid Injection and Carpal Tunnel Release in Patients With Carpal Tunnel Syndrome. Front Neurol 2021; 12.
Sveva V, Farì G, Fai A et al. Safety and Efficacy of Ultrasound-Guided Perineural Hydrodissection as a Minimally Invasive Treatment in Carpal Tunnel Syndrome: A Systematic Review. J Pers Med 2024; 14.
Zhou T, Wu Z, Gou X, Xia H, Ding J, Ai S. Local injection therapy for carpal tunnel syndrome: a network meta-analysis of randomized controlled trial. Front Pharmacol 2023; 14.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Julia Szalajska, Maria Wojcieszek, Natalia Wierzejska, Mikołaj Domański, Barbara Kopczyńska, Oliwia Czyżniewska, Karolina Czupryńska, Karina Otręba
![Creative Commons License](http://i.creativecommons.org/l/by-nc-sa/4.0/88x31.png)
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Stats
Number of views and downloads: 119
Number of citations: 0