Effectiveness of Conservative Treatment According to Severity and Systemic Disease in Carpal Tunnel Syndrome: A Systematic Review

Abstract

(1) Background: Carpal tunnel syndrome (CTS) is the most common peripheral neuropathy in the upper extremity. Conservative treatment has been effective for mild and moderate idiopathic CTS. However, severe CTS and systemic conditions were an exclusion criterion from the studies. The aim of this study is to review the effectiveness of conservative treatment in patients with CTS regardless of the level of severity and the presence or not of systemic diseases in the last ten years. (2) Methods: Randomized controlled clinical trials that compared the effect of conservative treatment on the Boston questionnaire and pain were selected. PubMed, PEDro, Scopus, Cochrane, and Web of Science databases were used. PRISMA statement checklist was performed. (3) Results: 876 studies were recorded, 29 were selected. Pharmacology, Electrotherapy and Manual Therapy had benefits for CTS. Electrotherapy and manual therapy could be effective for severe CTS patients with a systemic condition in the short term, but there was a low percentage of these patients included in the studies. (4) Conclusion: Some pharmacological treatments, manual therapy and electrotherapy have shown benefits for handling CTS, although the most effective combination of techniques is unknown. It would be necessary to include patients with systemic conditions in the selection criteria for future studies.

The effectiveness of manual therapy on pain, physical function, and nerve conduction studies in carpal tunnel syndrome patients: a systematic review and meta-analysis

“…The results of this meta-analysis are consistent with the previous systematic reviews that showed positive effects after manual therapy treatment on symptoms and function in patients with CTS [ 21 , 29 , 31 – 33 ]. In these reviews, the intervention included all conservative treatments, whereas in this meta-analysis, the effect of manual therapy interventions in isolation was analyzed.…”

“…The number of studies analyzing manual therapy interventions has increased in last years, and they have shown positive effects on symptoms and physical function in patients with CTS [14][15][16][17][18][19][20]. Although a recent review has assessed the effects of conservative treatments in patients with CTS [21], to the best of our knowledge, no systematic review with meta-analysis has been performed in order to assess the effectiveness of manual therapy on the main symptoms, function, and nerve conduction studies in patients with CTS [22,23].…”

Medical Rehabilitation Management of Carpal Tunnel Syndrome

“…Tatalaksana CTS diberikan berdasarkan beratnya penyakit. Pada kasus ringan dan sedang, direkomendasikan terapi konservatif (8). Penderita CTS berat atau kerusakan saraf pada pemeriksaan elektrodiagnostik dilakukan pembedahan dekompresi.…”

Comparative Efficacy of Routine Physical Therapy with and without Neuromobilization in the Treatment of Patients with Mild to Moderate Carpal Tunnel Syndrome

“…Other factors, for example, age, hereditary, and anthropometric components, have been implicated in the risk factors of idiopathic CTS [ 10 ]. Obesity, diabetes, and hypothyroidism have been associated with a double chance of developing CTS due to increased intraneural pressure in the carpal tunnel or vascular deficits [ 11 ].…”