Featured Research

from universities, journals, and other organizations

Optimal Treatment Of Carpal Tunnel Syndrome

Date:
February 7, 2005
Source:
John Wiley & Sons, Inc.
Summary:
Is surgery always the best course for carpal tunnel syndrome's sufferers? A team of researchers in Madrid recently set out to find the answer. The results of their clinical trial, published in the February 2005 issue of Arthritis & Rheumatism.

Carpal tunnel syndrome (CTS) is the most recognized occupational maladies as well as one of the most reported. Marked by numbness, weakness, and pain in the wrist and hand – particularly the thumb and index finger, and frequently shooting up the arm – CTS occurs when the median nerve, which runs from the forearm to the base of the palm, becomes compressed. This constriction or pinching is commonly attributed to repetitive motion and stress. Yet, in spite of its association with heavy computer use, carpal tunnel syndrome is not confined to data entry workers. Butchers, mechanics, musicians, dental hygienists, tennis players and golfers are vulnerable. According to recent studies, CTS affects about 3 percent of the general population, whether on the job or at play. Women are more likely than men to develop it. Individuals with rheumatoid arthritis are also at high risk.

Related Articles


Despite the prevalence of CTS and its considerable economic impact – in terms of both worker absenteeism and compensation claims – there is no universally accepted therapy. Mild cases are usually left untreated. Moderate cases may be treated with local injections of corticosteroids, if patients fail to respond to splinting and anti-inflammatory drugs like ibuprofen. In severe cases, with the threat of permanent loss of sensation, the preferred treatment is surgery. Surgery, however, is often recommended to patients before trying less invasive and less expensive treatments. Is surgery always the best course for carpal tunnel syndrome's sufferers? A team of researchers in Madrid recently set out to find the answer. The results of their clinical trial, published in the February 2005 issue of Arthritis & Rheumatism (http://www.interscience.wiley.com/journal/arthritis), suggest that local steroid injection is just as effective as surgery for the long-term symptomatic relief of CTS – for a year, at least – and actually more effective over the short term.

The research effort focused on the results of 163 wrists belonging to 101 patients – 93 women, 8 men – who were referred by their primary care physician to a CTS unit specifically created for this study. All the patients had experienced CTS symptoms – most notably, nightly attacks of extreme tingling and burning in the hand and fingers, which disrupted their sleep – for at least 3 months. Of the total wrists, 80 were randomly assigned to the standard surgical procedure: decompression of the median nerve. The remaining 83 wrists were treated with local steroid injection. Patients in both groups were similar in age – the median was 50 for the surgery group and 53 for the injection group – as well as in the duration and severity of their symptoms.

All wrists were evaluated 14 days after the initial treatment. At that time, 69 of the wrists that had been treated with steroids received a second local injection. Researchers then assessed the symptoms of both groups at 3, 6, and 12 months, using visual analog scale scores to measure improvement. At the 3-month mark, 94 percent of the wrists in the injection group achieved significant improvement – a response of 20 percent or better – for the nocturnal symptoms, compared with 75 percent of wrists in the surgery group. At the 6-month mark, 85.5 percent of wrists in the injection group achieved a 20 percent or better response for the nocturnal symptoms, compared with 76.3 percent in the surgery group. At the 12-month mark, 69.9 percent of the wrists in the injection group achieved a 20 percent or better response for the nocturnal symptoms, compared with 70 percent in the surgery group. Throughout follow-up, results for two other symptoms measured – daily pain in the wrist area and self-perceived functional impairment – were similar.

"This is the first randomized controlled clinical trial comparing the two most common therapies for CTS," notes one of its authors, Dr. Domingo Ly-Pen. "Our findings suggest that both local steroid injections and surgical decompression are highly effective in alleviating the symptoms of primary CTS at 12 months of follow-up. Nevertheless, local injection seems superior to surgery in the short term."

Also notably, more patients whose wrists were randomly assigned to surgery rejected the treatment (11 wrists) than did those whose wrists were assigned to injection (1 wrist). "This finding coincides with our daily clinical practice," Dr. Ly-Pen observes, "in which patients usually prefer conservative therapies." Surgery may still be the best course in severe cases of CTS, for avoiding loss of sensation and improving function. This study, however, has important implications for the effective, affordable, early treatment of carpal tunnel syndrome, an unfortunately common condition of our times.

###

Article: "Surgical Decompression Versus Local Steroid Injection in Carpal Tunnel Syndrome: A One-Year, Prospective, Randomized, Open, Controlled Clinical Trial," Domingo Ly-Pen, Jose-Luis Andreu, Gema de Blas, Alberto Sanchez-Olaso, and Isabel Millan, Arthritis & Rheumatism, February 2005; 52:2; pp. 612-619.


Story Source:

The above story is based on materials provided by John Wiley & Sons, Inc.. Note: Materials may be edited for content and length.


Cite This Page:

John Wiley & Sons, Inc.. "Optimal Treatment Of Carpal Tunnel Syndrome." ScienceDaily. ScienceDaily, 7 February 2005. <www.sciencedaily.com/releases/2005/02/050204214339.htm>.
John Wiley & Sons, Inc.. (2005, February 7). Optimal Treatment Of Carpal Tunnel Syndrome. ScienceDaily. Retrieved February 1, 2015 from www.sciencedaily.com/releases/2005/02/050204214339.htm
John Wiley & Sons, Inc.. "Optimal Treatment Of Carpal Tunnel Syndrome." ScienceDaily. www.sciencedaily.com/releases/2005/02/050204214339.htm (accessed February 1, 2015).

Share This


More From ScienceDaily



More Health & Medicine News

Sunday, February 1, 2015

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Hikers Rescued After Fall from Oregon Mountain

Hikers Rescued After Fall from Oregon Mountain

AP (Feb. 1, 2015) Two climbers who were hurt in a fall on Mount Hood are now being treated for their injuries. Rescue officials say they were airlifted off the mountain Saturday afternoon by an Oregon National Guard helicopter. (Feb. 2) Video provided by AP
Powered by NewsLook.com
Smart Glasses Augment Reality to Help Visually Impaired

Smart Glasses Augment Reality to Help Visually Impaired

Reuters - Innovations Video Online (Feb. 1, 2015) New augmented reality smart glasses developed by researchers at Oxford University can help people with visual impairments improve their vision by providing depth-based feedback, allowing users to "see" better. Joel Flynn reports. Video provided by Reuters
Powered by NewsLook.com
Flu Season Hitting Elderly Hard

Flu Season Hitting Elderly Hard

Reuters - US Online Video (Jan. 31, 2015) The CDC says this year&apos;s flu season is hitting people 65 years of age and older especially hard. Linda So reports. Video provided by Reuters
Powered by NewsLook.com
CDC: Get Vaccinated for Measles

CDC: Get Vaccinated for Measles

Reuters - US Online Video (Jan. 30, 2015) The CDC is urging people to get vaccinated for measles amid an outbreak that began at Disneyland and has now infected more than 90 people. Linda So reports. Video provided by Reuters
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins