SynthesisAnnals of family medicine
What can family physicians offer patients with carpal tunnel syndrome other than surgery? A systematic review of nonsurgical management.
Synthesis in Annals of family medicine. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 6 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
25 citing papers in PubMed, 6 syntheses or guidelines pooled it.
- Quality analysis of prior systematic reviews of carpal tunnel syndrome: an overview of the literature.Sao Paulo medical journal = Revista paulista de medicina · 2022Pooled it
- Effect of Platelet-Rich Plasma Injection on Mild or Moderate Carpal Tunnel Syndrome: An Updated Systematic Review and Meta-Analysis of Randomized Controlled Trials.BioMed research international · 2020Pooled it
- Therapeutic ultrasound for carpal tunnel syndrome.The Cochrane database of systematic reviews · 2013Pooled it
- Splinting for carpal tunnel syndrome.The Cochrane database of systematic reviews · 2012Pooled it
- Exercise and mobilisation interventions for carpal tunnel syndrome.The Cochrane database of systematic reviews · 2012Pooled it
- Ergonomic positioning or equipment for treating carpal tunnel syndrome.The Cochrane database of systematic reviews · 2012Pooled it
- Trial
- Comparison of Two Manual Therapy Programs, including Tendon Gliding Exercises as a Common Adjunct, While Managing the Participants with Chronic Carpal Tunnel Syndrome.Pain research & management · 2022Trial
- 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 musculoskeletal disorders · 2006Trial
- A comparison of the lidocaine patch 5% vs naproxen 500 mg twice daily for the relief of pain associated with carpal tunnel syndrome: a 6-week, randomized, parallel-group study.MedGenMed : Medscape general medicine · 2006Trial
- Article
- Current Insights into Carpal Tunnel Syndrome: Clinical Strategies for Prevention and Treatment.Current drug targets · 2024Review
- Splinting for carpal tunnel syndrome.The Cochrane database of systematic reviews · 2023Review
- Effectiveness of ultrasound and median nerve gliding with and without shock-wave therapy in patients with moderate carpal tunnel syndrome.Journal of physical therapy science · 2022Article
- The Effect of Acupuncture on Hand and Wrist Pain Intensity, Functional Status, and Quality of Life in Adults: A Systematic Review.Medical acupuncture · 2022Review
- Ultrasound-Guided Hydroneurolysis of the Median Nerve for Recurrent Carpal Tunnel Syndrome.Hand (New York, N.Y.) · 2019Article
- Effectiveness of Low-Level Laser Therapy compared to Ultrasound in Patients With Carpal Tunnel Syndrome: A Systematic Review and Meta-analysis.Journal of lasers in medical sciences · 2019Review
- Treatment of mild to moderate carpal tunnel syndrome in patients with diabetic neuropathy using low level laser therapy versus ultrasound controlled comparative study.BBA clinical · 2017Article
- Efficacy of tendon and nerve gliding exercises for carpal tunnel syndrome: a systematic review of randomized controlled trials.Journal of physical therapy science · 2015Review
- Factors affecting symptoms and functionality of patients with carpal tunnel syndrome: a retrospective study.Journal of physical therapy science · 2015Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWe undertook a literature review to produce evidence-based recommendations for nonsurgical family physician management of carpal tunnel syndrome (CTS).
methodsStudy design was systematic review of randomized controlled trials (RCTs) on CTS treatment. Data sources were English publications from all relevant databases, hand searches, and guidelines. Outcomes measured were nonsurgical management options for CTS.
resultsWe assessed 2 systematic reviews, 16 RCTs, and 1 before-and-after study using historical controls. A considerable percentage of CTS resolves spontaneously. There is strong evidence that local corticosteroid injections, and to a lesser extent oral corticosteroids, give short-term relief for CTS sufferers. There is limited evidence to indicate that splinting, laser-acupuncture, yoga, and therapeutic ultrasound may be effective in the short to medium term (up to 6 months). The evidence for nerve and tendon gliding exercises is even more tentative. The evidence does not support the use of nonsteroidal anti-inflammatory drugs, diuretics, pyridoxine (vitamin B6), chiropractic treatment, or magnet treatment.
conclusionsFor those who are not able to get surgery or for those who do not want surgery, there are some conservative modalities that can be tried. These modalities include ones for which there is good evidence. It would be reasonable to try some of the techniques with less evidence if the better ones are not successful. Reconsideration of surgery must always be kept in mind to avoid permanent nerve damage.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.