Carpal Tunnel Syndrome: Therapy [Clinical Review Discussion]

Carpal tunnel syndrome (CTS) is a common clinical diagnosis associated with significant morbidity.  Conservative treatment options, many which demonstrate promising treatment effects, have not been adequately investigated.  The following list is comprised of treatments that have been studied at least on a limited basis.  If a specific treatment is not on the list, it is because no studies have been performed or located.  A significant concern with several of the published articles is “multiple treatment interface”.  This occurs when the investigator treats patients with more than one intervention at the same time.  An example would be a test group being treated with ultrasound (US) and vitamin B6 at the same time.  If improvement is noted one must ask the question “could the B6 alone or ultrasound alone lead to the improvement or was it the combination of B6 and ultrasound?”  This research design makes identifying the effective treatment difficult.