Carpal tunnel syndrome conservative treatment: a literature review

Purpose
Carpal tunnel syndrome (CTS) is the most common compression neuropathy, which is associated with a significant psychosocial and economic burden. In this paper, the literature on the current knowledge about the physiology and pathology of peri­pheral nerves during the course of CTS is reviewed, with a focus on currently used treatment options and the rationale for their use. Epidemiology, risk factors, etiology, clinical features and conservative treatment have been searched for, with all full-text, English language articles being included in the study. This paper aims to present the recent findings on CTS treatment while also suggesting a direction for further clinical trials.

Views
The search in PubMed and Google Scholar Databases revealed 229 articles of which 71 met the research criteria. The evidence regarding standard treatment methods of conservative CTS treatment is presented. CTS is a relatively common condition, which affects women more often than men. It is a multifactorial disease, and its clinical presentation mostly consists of symptoms distal to the entrapment site, including numbness, tingling, weakness and pain. Electrodiagnostic studies are considered to be the gold standard in CTS diagnosis. The conservative treatment methods reviewed are acupuncture, extracorporeal shock wave therapy, hydrodissection, kinesiotaping, corticosteroid injection, low level laser therapy, splints, platelet-rich plasma injection, manual therapy, ultrasound and phonophoresis.

Conclusions
Based on the current body of knowledge, we conclude that the conservative CTS treatment is very safe, but the effectiveness of reviewed methods differs. The first promising results presented by various studies motivate the need for further research on novel treatment methods.