Background: Conservative therapies are typically offered to individuals who experience mild or intermittent symptoms of carpal tunnel syndrome (CTS) or postoperatively to subjects who have undergone carpal tunnel release. Although long-term studies report mostly positive results for carpal tunnel release, knowledge on the need for conservative treatments following surgery is scarce. The aim of this retrospective cohort study was to examine the use of conservative therapies before and after carpal tunnel releasing surgery.
Methods: Of 528 patients who underwent carpal tunnel release surgery in the study hospital during the study period, 259 provided sufficiently completed questionnaires (response rate 49 %). The patients completed a questionnaire battery including a sociodemographic, medical history and symptom questionnaire, the Boston Carpal Tunnel Syndrome Questionnaire, 6-item CTS symptoms scale and EuroQoL 5D. Frequencies of conservative therapies pre- and postoperatively were calculated. Association between Pain VAS and satisfaction with treatment were examined in patient groups according to the use of conservative therapies.
Results: Of all patients, 41 (16 %) reported receiving only preoperative, 18 (7 %) reported receiving only postoperative, 157 (60 %) reported receiving both pre- and postoperative conservative therapies and 43 (17 %) did not receive any therapies. Preoperative use of conservative therapies was more common in females than males (82 % vs. 64 %; p = 0.002), but postoperatively no significant gender difference was observed. The patients who received conservative therapies were younger than non-users in both the preoperative (median age 59 vs. 66; p < 0.001) and postoperative (59 vs. 66; p = 0.04) phases. The patients reported high satisfaction with their treatment and simultaneous improvement in Pain VAS scores. Those receiving conservative therapies only preoperatively reported the highest satisfaction.
Conclusions: While the use of conservative therapies decreased after surgery, a large proportion of the patients received these adjunct interventions. Patients reported high satisfaction with their treatment one year post surgery. Pain outcome seems to be closely related to satisfaction with treatment.
Level Of Evidence: Level III.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8157685 | PMC |
http://dx.doi.org/10.1186/s12891-021-04378-3 | DOI Listing |
Muscle Nerve
January 2025
Department of Neurology, Teikyo University School of Medicine, Tokyo, Japan.
Introduction: Extrapolated reference values (E-Ref) procedure is a new method for determining the cutoff value without collecting the control data. We tried to apply this method to determine the cutoff value for the distal motor latency of the median nerve (median DML). During this process, we found two pitfalls of the E-Ref method.
View Article and Find Full Text PDFInt Orthop
January 2025
Stanford Medicine, Stanford, CA, USA.
Purpose: Subclinical peroneal neuropathy without overt foot drop has been linked to increased fall risk in adults, yet remains under reported due to subtle symptoms and lack of awareness. Patients with carpal tunnel syndrome (CTS) often experience other nerve entrapments, prompting this study to evaluate CTS (a proxy for peroneal nerve entrapment) as a significant predictor of time to first fall.
Methods: Data from the Merative MarketScan Research Databases (2007-2021) were used to identify adult patients using ICD-9/10 codes.
Ultrasound Med Biol
January 2025
Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA. Electronic address:
Objective: Measurement of thenar muscle elasticity by ultrasound shear wave elastography (SWE) may be useful for the diagnosis and evaluation of carpal tunnel syndrome (CTS), but there is a paucity of information on SWE of the thenar muscles in patients with CTS. The purpose of this study was to investigate the elasticity of the thenar muscles in patients with CTS.
Methods: Twenty-two adult patients with a referral diagnosis of CTS (27 hands) and 20 healthy volunteers as a control (20 dominant hands) participated in this study.
Arch Orthop Trauma Surg
January 2025
Orthopedics Research Center, Mashhad University of Medical Science, Mashhad, Iran.
Introduction: There exist conflicting electrodiagnostic reports between diagnosing mild carpal tunnel syndrome (CTS) and normal results, depending on the interpretation methods used by electrodiagnosticians. This underscores the necessity for precise clinical guidelines. This study aims to assess how the variation between mild and normal electrophysiological reports impacts (1) subsequent clinical outcomes in patients diagnosed with CTS and (2) physicians' decision-making.
View Article and Find Full Text PDFAm J Phys Med Rehabil
December 2024
Department of Physical Medicine and Rehabilitation, R. G. Kar Medical College & Hospital, Kolkata, India.
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