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Surgical vs Nonsurgical Treatments for Carpal Tunnel Syndrome
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Journal Article
Surgical vs Nonsurgical Treatments for Carpal Tunnel Syndrome
2025
Overview
Clinical practice guidelines recommend surgical referral for patients with severe symptoms, thenar atrophy, or positive findings on electrodiagnostic testing.5 Mild to moderate CTS should be treated with splinting, injections, occupational therapy, or surgery.4 The 2024 Cochrane review discussed here evaluated the benefits and harms of surgical vs various nonsurgical treatments for CTS in adults.6 The systematic review found 14 randomized controlled trials (RCTs) comparing surgery vs splinting, corticosteroid injection, splinting plus corticosteroid injection, platelet-rich plasma injection, manual therapy, multimodal nonoperative treatment, and unspecified medical treatment and hand support. [...]this review compared outcomes from treatment-naive patients, limiting the applicability to this population and its generalizability to patients who have already been treated with nonsurgical therapies. Additionally, the evidence is uncertain about whether surgery vs corticosteroid injection results in beneficial long-term clinical improvement or difference in harms. [...]shared decision-making should be used, considering disease severity and duration, along with patient concerns, previous treatments, occupation, goals, and preferences.
Publisher
American Academy of Family Physicians
