Carpal tunnel syndrome medical therapy
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Dheeraj Makkar, M.D.[2]
Overview
CTS treatment should be started as soon as possible. More frequent breaks and applying cold packs are helpful in reducing swelling. Other treatment options are wrist surgical and nonsurgical options.
Treatment
Nonoperative
- NSAIDS, night splints, activity modifications
indications first line of treatment modalities night splints (good for patients with nocturnal symptoms only)
activity modification (avoid aggravating activity)
- steroid injections
- indications
1.adjunctive nonoperative treatment
2.diagnostic utility in clinically and electromyographically equivocal cases (ie cervical radiculopathy and pronator syndrome) outcomes 80% have transient improvement of symptoms (of these 20% remain symptom-free at one year) failure to improve after injection is poor prognostic factor surgery is less effective in these patients
Operative
- carpal tunnel release
- indications
failure of nonoperative treatment (including steroid injections) temporary improvement with steroid injections is a good prognostic factor that the patient will have a good result with surgery) acute CTS following trauma or ORIF
- technique
- open
- endoscopic
Alternative medicine
- Yoga
- Hand therapy
- High-intensity Ultrasound therapy