Document Detail


Carpal tunnel syndrome. Part I: effectiveness of nonsurgical treatments--a systematic review.
MedLine Citation:
PMID:  20599038     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To review literature systematically concerning effectiveness of nonsurgical interventions for treating carpal tunnel syndrome (CTS).
DATA SOURCES: The Cochrane Library, PubMed, EMBASE, CINAHL, and PEDro were searched for relevant systematic reviews and randomized controlled trials (RCTs).
STUDY SELECTION: Two reviewers independently applied the inclusion criteria to select potential studies.
DATA EXTRACTION: Two reviewers independently extracted the data and assessed the methodologic quality.
DATA SYNTHESIS: A best-evidence synthesis was performed to summarize the results of the included studies. Two reviews and 20 RCTs were included. Strong and moderate evidence was found for the effectiveness of oral steroids, steroid injections, ultrasound, electromagnetic field therapy, nocturnal splinting, and the use of ergonomic keyboards compared with a standard keyboard, and traditional cupping versus heat pads in the short term. Also, moderate evidence was found for ultrasound in the midterm. With the exception of oral and steroid injections, no long-term results were reported for any of these treatments. No evidence was found for the effectiveness of oral steroids in long term. Moreover, although higher doses of steroid injections seem to be more effective in the midterm, the benefits of steroids injections were not maintained in the long term. For all other nonsurgical interventions studied, only limited or no evidence was found.
CONCLUSIONS: The reviewed evidence supports that a number of nonsurgical interventions benefit CTS in the short term, but there is sparse evidence on the midterm and long-term effectiveness of these interventions. Therefore, future studies should concentrate not only on short-term but also on midterm and long-term results.
Authors:
Bionka M Huisstede; Peter Hoogvliet; Manon S Randsdorp; Suzanne Glerum; Marienke van Middelkoop; Bart W Koes
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Archives of physical medicine and rehabilitation     Volume:  91     ISSN:  1532-821X     ISO Abbreviation:  Arch Phys Med Rehabil     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-07-05     Completed Date:  2010-07-23     Revised Date:  2011-01-07    
Medline Journal Info:
Nlm Unique ID:  2985158R     Medline TA:  Arch Phys Med Rehabil     Country:  United States    
Other Details:
Languages:  eng     Pagination:  981-1004     Citation Subset:  AIM; IM    
Copyright Information:
Copyright 2010 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of General Practice, Erasmus Medical Center, Rotterdam, The Netherlands. b.huisstede@erasmusmc.nl
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MeSH Terms
Descriptor/Qualifier:
Adrenal Cortex Hormones / therapeutic use*
Carpal Tunnel Syndrome / therapy*
Complementary Therapies
Dietary Supplements
Exercise Therapy
Humans
Magnetic Field Therapy
Physical Therapy Modalities*
Randomized Controlled Trials as Topic
Splints
Ultrasonic Therapy
Chemical
Reg. No./Substance:
0/Adrenal Cortex Hormones
Comments/Corrections
Comment In:
Ann Intern Med. 2010 Dec 21;153(12):JC6-10   [PMID:  21173399 ]

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