Treatments

A search of the internet will reveal a bewildering number of remedies for CTS. The ones I have come across are listed in these pages but I am always interested to hear of others. Only three interventions have been conclusively shown to be of benefit in randomised controlled clinical trials:

Surgery
 - Open
 - Endoscopic

Steroids - by local injection, orally, or transcutaneously by iontophoresis or phonophoresis

Splinting (Conventional ‘futuro’ -off the shelf or custom built or various more exotic splint designs proposed by individual authors)

Other conventional and 'alternative' treatments have not as yet been proven to help.

The most promising data on the alternatives relates to local ultrasound and to ligament stretching devices but results are contradictory at present. On this site you will find a summary of important treatment trials and details of trials we are thinking of carrying out in Canterbury.

PROGNOSIS - the art of predicting the outcome of treatment

What the patient primarily needs to know in order to choose a treatment are the likely outcomes:

1. Benefits - whether the symptoms will improve and by how much
2. Risks/Side effects - could the condition itself get worse or could treatment cause problems itself

Outcomes of CTS treatment cannot be predicted reliably but some patients are more likely to benefit from treatment than others. Prognosis for surgical treatment has been studied more extensively than other interventions. We are currently looking into the possibility of creating a personalised outcome prediction on this site using methods similar to those used in the diagnostic questionnaire. Much less is known about prognosis for non-surgical treatments.

Revision date - 27th November 2011