What is the evidence for conservative (non-surgical) measures to treat carpal tunnel syndrome?
AMSTAR Rating
Summary
Patient Population:
Patients with a clinical diagnosis of carpal tunnel syndrome.
2 Cochrane reviews and 26 recent RCTs (25 from PubMed 1 from PEDro, none from EMBASE or CINAHL) met inclusion criteria.
Intervention:
Non-surgical interventions to treat carpal tunnel syndrome.
Comparison:
Control (no-treatment) or another non-surgical treatment.
Outcome:
Short-term:
Strong evidence: Oral steroids, Injectable steroids
Moderate evidence: Ultrasound, Nocturnal hand brace, Ergonomic keyboard, Dynamic magnetic field therapy, Cupping therapy.
Mid-term:
Moderate evidence: Ultrasound, Oral methylprednisone 60mg (> 20 or 40mg)
Long-term:
None
Outcomes Assessed
- Benefit
- Harm
- Inconclusive
Physiotherapy
Ultrasound (Short and Mid-term)
Oral
Methylprednisone 60mg (Strong)
Injection
Corticosteroid (Strong)
Other
Ergonomic keyboard
Splinting (Night)
Magnetic field therapy
Relevant Clinical Info
Strong evidence = consistent, positive findings from multiple higher-quality RCTs
Moderate evidence = consistent, positive findings from multiple lower-quality RCTs or one higher-quality RCT.
Limited evidence = positive findings from one lower-quality RCT.
