Surgery Best for Carpal Tunnel Syndrome

Operation has modest advantage over non-surgical therapies, researchers say

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THURSDAY, Sept. 24 (HealthDay News) -- Surgery is slightly better than non-surgical treatment for patients with carpal tunnel syndrome who don't have severe nerve damage (denervation), new research has found.

The study included 44 patients who had surgery and 52 patients who had non-surgical treatment, such as hand therapy and ultrasound. A year after treatment, the patients' hand function was measured using the Carpal Tunnel Syndrome Assessment Questionnaire (CTSAQ).

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The patients who had surgery showed an advantage in both function and symptoms -- calculated by proportions of patients having at least 30 percent improvement in CTSAQ scores for these indicators, and having minimal interference in daily work or household activities. The study found that 46 percent of surgery patients and 27 percent of non-surgery patients met all three criteria.

"Overall, these data indicate that, in patients with carpal tunnel syndrome without denervation, surgery modestly improves hand function and symptoms by three months compared with a multimodality non-surgical treatment regimen, and this benefit is sustained through one year," wrote Dr. Jeffrey Jarvik, of Harborview Medical Center at the University of Washington in Seattle, and colleagues.

"However," they continued, "some patients allocated to surgery reported persistent symptoms, and 61 percent of patients allocated to non-surgical treatment avoided surgery altogether. Our study, together with previous evidence, indicates that surgery is useful for patients with carpal tunnel syndrome."

The study appears online Sept. 24 in a special surgery issue of The Lancet.

Patient treatment preference is an important factor, two Swedish doctors noted in an accompanying editorial. When patients are "faced with the need to wear a splint each night and during daytime for some weeks, some might prefer early surgery while others may prefer partial recovery to potential surgical risk," wrote Dr. Isam Atroshi and Christina Gummesson, both of Lund University.

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