Long-term outcome of carpal tunnel syndrome after conservative treatment

2004 ◽  
Vol 58 (4) ◽  
pp. 337-339 ◽  
Author(s):  
A.C.F. Hui ◽  
S.M. Wong ◽  
A. Tang ◽  
V. Mok ◽  
L.K. Hung ◽  
...  
2010 ◽  
Vol 35 (10) ◽  
pp. 32-33
Author(s):  
Raymond A. Pensy ◽  
Frank D. Burke ◽  
Mary J. Bradley ◽  
Norman H. Dubin ◽  
E.F. Shaw Wilgis

Author(s):  
Tsung-Ying Li ◽  
Si-Ru Chen ◽  
Yu-Ping Shen ◽  
Chih-Ya Chang ◽  
Yu-Chi Su ◽  
...  

Abstract Objective Perineural injection therapy with 5% dextrose water is progressively becoming a mainstream method for treating carpal tunnel syndrome. However, its long-term outcome is still unknown. Hence, the purpose of this retrospective study was to investigate the long-term outcome after perineural injection therapy using 5% dextrose water. Methods A total of 185 patients diagnosed with carpel tunnel syndrome at least 1 year post-therapy were enrolled. All the patients underwent ultrasound-guided perineural injection therapy using 10 ml of 5% dextrose water at the outpatient department. In a structured telephone interview, the patients were asked about the outcome post-therapy compared with pre-injection. A symptom relief ≥50% indicated effective outcome, and a symptom relief <50% was indicative of a poor outcome. Results In total, 88.6% patients reported an effective outcome, and 11.4% rated the outcome as poor, after a mean of 2.2 injections with a mean of 1–3 years’ post-injection follow-up. The outcome was significantly related with severity level, and the patients that reported a poor outcome had a significantly higher incidence of severe grade compared with those who reported an effective outcome (52.4% vs 31.7%, P = 0.03). Patients with mild, moderate and severe grades, respectively, required an average of 1.7 (0.1), 2.4 (0.2) and 2.6 (0.3) injections to reach an effective outcome (P = 0.006) (severe vs mild, P = 0.008; moderate vs mild, P = 0.062). Conclusion Perineural injection therapy is a novel approach for treatment of carpal tunnel syndrome with safe and outstanding long-term effects.


2020 ◽  
Vol 10 (1) ◽  
pp. 75-81
Author(s):  
Md Ruhul Kuddus ◽  
Md Omar Faruk ◽  
Samiul Alam ◽  
KM Atiqul Islam ◽  
Shamsul Alam ◽  
...  

Background: Carpal Tunnel Syndrome (CTS) is the most common form of entrapment neuropathy. Both the Medical and surgical treatments are popular in the management of CTS. The effectiveness of the surgical treatment of carpal tunnel syndrome (CTS) is well known on short term. Surgical approach has proved to be more efficient relative to the conservative methods of steroid injections and splinting. On the other hand, many studies have demonstrated both advantages and adverse effects of the surgical methods. However, limited data is available about long-term outcome after carpal tunnel release (CTR). So debate is still persists regarding Conservative vs. Surgical approach to treatment of CTS. Methods: A retrospective analysis of 15 consecutive cases performed during 1.5 year was conducted. 8 patients were treated surgically with transpalmar approach. 7 patient were treated conservatively. The criteria for treatment efficacy were improvements in symptoms, such as pain, paresthesia and recurrences after surgery. Results: Female were predominant 80% than male 20%. Right hand was more frequently affected 80% than left 20%. most paitents were diabetic except 2. outcome in the surgical group was excellent. Patient of non-surgical group was not satisfied as surgical group. Conclusions: CTR is a robust treatment for CTS and its effect persists after a period of years. CTR is the choice of treatment in case of moderate to severe form of CTS. Long term follow up and inclusion of more cases is needed for a definite conclusion. Bang. J Neurosurgery 2020; 10(1): 75-81


Hand ◽  
2018 ◽  
Vol 15 (1) ◽  
pp. 13-22 ◽  
Author(s):  
Qiyun Shi ◽  
Pavlos Bobos ◽  
Emily A. Lalone ◽  
Laura Warren ◽  
Joy C. MacDermid

Background: The objective of the study is to examine the short-term and long-term efficacy of surgical treatment of carpal tunnel syndrome (CTS) compared with conservative treatment (ie, splint, steroid injection, or physical therapy). Methods: Two reviewers searched the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, and PEDro up to September 2017. Quality appraisal and data extraction were performed in duplicate. Patient self-reported functional and symptom changes, as well as improvement of electrophysiological studies, were assessed as outcomes. Meta-analyses were performed in RevMan. Results: From 1438 studies identified after searching, 10 remained for analysis after exclusion criteria were applied. Moderate-quality evidence indicated that surgical interventions were superior to splint or steroid injection at 6 months with a weighted mean difference of 0.25 (95% confidence interval [CI], 0.07-0.44) for functional status and 0.64 (95% CI, 0.07-1.21) for symptom severity. The surgical group had better nerve conduction outcomes at 6 months (0.57 [95% CI, 0.05-0.50] ms). No significant differences were observed at 3 or 12 months. Conclusions: Both surgical and conservative interventions provide treatment benefits in CTS. Further studies on long-term outcome are needed.


PeerJ ◽  
2019 ◽  
Vol 7 ◽  
pp. e8012 ◽  
Author(s):  
Tomasz Wolny ◽  
Pawel Linek

Background Physiotherapy of carpal tunnel syndrome (CTS) involves manual therapy based on neurodynamic techniques. Until now, two randomized controlled trials have shown that immediately after therapy, CTS patients who received neurodynamic techniques had significant improvement in nerve conduction, pain, symptom severity (SSS), functional state (FSS), muscle strength (MS) and two-point discrimination (2PD). However, long-term effects seem to be more important, as they are the only ones that can significantly improve the patient’s health and influence economic and social costs. Thus, the objective of this study was to evaluate the long-term (six months) effects of neurodynamic techniques in the conservative treatment of CTS patients. Methods Carpal tunnel syndrome patients (107) from two previously published randomised clinical trials were observed for six months after the treatment based on neurodynamic techniques. Results The sensory conduction velocity, motor conduction velocity, and motor latency were not subject to statistically significant changes within six months after therapy (p > 0.05). In both groups, there was further pain reduction (p < 0.05). In Group B, the symptom severity improved significantly (p < 0.05), while the functional status in both groups remained unchanged (p > 0.05). In both groups, there was muscle strength improvement (p < 0.05). Two-point discrimination remained unchanged six months after the therapy. Conclusion The use of manual therapy based on neurodynamic techniques maintains the beneficial effects 6 months after therapy in CTS patients.


Hand Surgery ◽  
1996 ◽  
Vol 01 (02) ◽  
pp. 95-101
Author(s):  
Adriel A. Kramer ◽  
Arnold-Peter C. Weiss ◽  
Hans-J. Barrach ◽  
Edward Akelman

Carpal tunnel syndrome (CTS) and trigger finger (TF) are two related disorders which involve alterations in the normal mechanical loading of tendon sheath pulleys. This study examines the presence of Type II collagen in the carpal ligament and A-1 pulley by Western blotting to determine the extent of cartilage metaplasia that may occur in these tissues. Cyanogen bromide peptides generated from tissue supplied from 77 patients were separated by SDS-PAGE and transferred to nitrocellulose. The membranes were stained with the E1E5 monoclonal antibody and collagen levels were quantified. All specimens were found to contain at least small amounts of Type II collagen. Approximately 15 percent of the samples from patients with carpal tunnel syndrome and trigger finger were found to contain significantly elevated levels of Type II collagen. All specimens with high levels of Type II collagen were found in female patients. These increases may indicate the presence of cartilage metaplasia enabling the tissue to counteract compressive loads. With further study, tissue staining techniques using monoclonal antibodies may provide useful clinical information on severity or long-term outcome prognosis.


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