Resolution of symptoms and preservation of hand function are goals of Carpal Tunnel Syndrome treatment, which includes non-surgical (or "conservative") treatment and surgical treatment. A significant number of Carpal Tunnel Syndrome patients will improve with no treatment which may help explain why many unproven alternative therapies claim success.
Conservative Treatment
The consensus of medical opinion is that, in the majority of cases, a course of appropriate conservative management of Carpal Tunnel Syndrome should be attempted before advising surgery, except in cases with:
- Obvious thenar wasting
- Severe sensory disturbance
- History of acute or traumatic onset
Under these circumstances, expedited medical and surgical assessment is required in the initial treatment phase due to the risk of progressive and permanent neurological damage.
Treatment of coexisting medical conditions that may cause or contribute to Carpal Tunnel Syndrome should be attempted and may be effective.
Medication
Optional medications:
- NSAIDs (unlikely to have further effect after one month and may cause GI complications).
- Local injection of corticosteroids for Carpal Tunnel Syndrome associated with tenosynovitis or stenosing tenosynovitis (maximum 3 injections at 4-6 week intervals if there is significant improvement after each injection). There are inherent risks of repeated steroid injection.
- Oral steroids
- Narcotic analgesics
- Vitamin B-6
Physical Therapies
Wrist splints with palmar reinforcements can sometimes be effective in the treatment of carpal tunnel syndrome, as they maintain the wrist in a neutral position.
