Carpal tunnel syndrome is the commonest peripheral nerve compression neuropathy and as such is frequently seen by hand therapists. Patients presenting with carpal tunnel syndrome are seen both in the primary and tertiary (hospital) settings and are referred for treatment at various stages of the disease process. The provision of splintage alone is viewed by some healthcare providers as conservative management for this condition. The purpose of this paper is to give a broad overview of conservative management options including posture and exercise, task modifications, splints, nerve and tendon-gliding exercises and ultrasound. It is the view of the authors that early and comprehensive treatment may relieve symptoms and potentially decrease the need for operative intervention, in the short to middle term at least, for patients with mild to moderate symptoms.