Carpal Tunnel Syndrome

Conservative Treatments of Carpal Tunnel Syndrome: A Systematic Review and Network Meta-analysis.

Chen Y, Han B, Zhang X, Guo C, Han Q, Zhang Z · Archives of physical medicine and rehabilitation · 2025 · n=3323

To evaluate the comparative efficacy of various conservative treatments for carpal tunnel syndrome (CTS), including manual therapy (MT), local steroid injections, platelet-rich plasma (PRP) injections, extracorporeal shock wave therapy, and low-level laser therapy, through a comprehensive network meta-analysis. PubMed, Web of Science, Cochrane Library, Embase, SPORTDiscus, and China National Knowledge Infrastructure databases were searched to identify published studies until April 2024. Randomized controlled trials comparing the efficacy of conservative CTS treatments in individuals with CTS were included. Data from the included articles were extracted independently by 2 researchers, with any disagreements resolved through consultation with a third author. The extracted data included the first author's name, country/region, publication year, sample size, participants' age, disease severity, symptom duration, intervention parameters, follow-up period, and reported outcomes. A total

Ultrasound-Guided Nerve Hydrodissection for the Management of Carpal Tunnel Syndrome: A Systematic Review and Network Meta-Analysis.

Lee K, Park JM, Yoon SY, Kim MS, Kim YW, Shin JI · Yonsei medical journal · 2025 · n=458

Ultrasound-guided nerve hydrodissection has emerged as a potential non-surgical treatment for carpal tunnel syndrome (CTS). The objective of this research was to offer suggestions for optimizing injectables utilized in hydrodissection for the treatment of CTS through a systematic review and network meta-analysis. PubMed, MEDLINE, EMBASE, Cochrane, Scopus, and Web of Science were searched through April 25, 2024. Effect sizes were quantified using standard mean differences within a random-effects model. Effectiveness ranking for each treatment was expressed as the surface under the cumulative ranking curve (SUCRA). Nine studies with 458 patients with CTS were included. According to SUCRA, 5% dextrose (DW) was the most effective option for the Boston Carpal Tunnel Questionnaire (BCTQ) function at 99.9, 89.8, and 88.8 at 4, 12, and 24 weeks, respectively; for BCTQ symptoms, 5% DW was the most effective option at 99.9 at 4 weeks and platelet-rich plasma at 95.7 and 93.9 at 12 and 24 weeks

A systematic review and meta-analysis of the effectiveness of high-intensity laser therapy in patients with carpal tunnel syndrome.

de la Barra Ortiz HA, Avila MA, Parizotto NA, Liebano RE · Physiotherapy · 2025

This systematic review aimed to evaluate the effects of high-intensity laser therapy (HILT) on pain intensity, disability, and electrophysiological parameters in individuals diagnosed with carpal tunnel syndrome (CTS). A search of electronic databases, including PubMed, Web of Science, Scopus, CINAHL, Science Direct, Cochrane Library, the PEDro database, and Google Scholar (updated until February 18, 2025), was conducted for randomized controlled trials (RCTs). Data were extracted independently by three researchers. The quality of RCTs was assessed using the Cochrane Risk of Bias (RoB) 2.0 tool, while evidence certainty was evaluated with the GRADE approach. Primary outcomes included pain intensity, with secondary outcomes comprising electrophysiological parameters and disability. Nine RCTs met inclusion criteria. Most studies exhibited a low risk of bias across RoB2 domains, except for outcome measurement, resulting in an overall RoB of 44%. Meta-analyses demonstrated that HILT, al

Comparison of Diagnostic Modalities for Carpal Tunnel Syndrome: A Systematic Review.

Gay ME, Lima JG, Vieites V, Belnap SC, Morgan R · Cureus · 2025

Carpal tunnel syndrome (CTS) is a common nerve entrapment disorder that affects millions, particularly older adults and women. It causes numbness, tingling, and discomfort in the hand, primarily affecting the median nerve. Risk factors include occupation (e.g., jobs involving repetitive motion or vibrating tools) and conditions such as obesity, pregnancy, and diabetes. Accurate diagnosis is critical for effective treatment, with nerve conduction studies (NCS) and ultrasound (US) being two key diagnostic methods. Each approach has strengths, limitations, and diagnostic utility, necessitating a comparison to determine the best use case for each tool. This comprehensive systematic review aims to compare the diagnostic accuracy and clinical utility of NCS and US in diagnosing CTS and provide conclusions on the most appropriate modality in different clinical scenarios.  A PubMed literature review conducted in August 2024 identified 49 studies. Of these, 31 were excluded for design and

L-Carnitine in the Treatment of Psychiatric and Neurological Manifestations: A Systematic Review.

Wang W, Pan D, Liu Q, Chen X, Wang S · Nutrients · 2024

L-carnitine (LC), a vital nutritional supplement, plays a crucial role in myocardial health and exhibits significant cardioprotective effects. LC, being the principal constituent of clinical-grade supplements, finds extensive application in the recovery and treatment of diverse cardiovascular and cerebrovascular disorders. However, controversies persist regarding the utilization of LC in nervous system diseases, with varying effects observed across numerous mental and neurological disorders. This article primarily aims to gather and analyze database information to comprehensively summarize the therapeutic potential of LC in patients suffering from nervous system diseases while providing valuable references for further research. A comprehensive search was conducted in PubMed, Web Of Science, Embase, Ovid Medline, Cochrane Library and Clinicaltrials.gov databases. The literature pertaining to the impact of LC supplementation on neurological or psychiatric disorders in patients was revie

Aromatase Inhibitor-Induced Carpal Tunnel Syndrome and Stenosing Tenosynovitis: A Systematic Review.

Chung KY, Ho G, Novak CB, Baltzer HL · Plastic and reconstructive surgery · 2022

Although aromatase inhibitors are the first-line treatment in postmenopausal women with hormone receptor-positive breast cancer, there is increasing evidence that they can induce carpal tunnel syndrome and stenosing tenosynovitis. This systematic review summarizes the risk factors, incidence, and management for patients with aromatase inhibitor-induced carpal tunnel syndrome and stenosing tenosynovitis compared to tamoxifen or placebo. A Preferred Reporting Items for Systematic Reviews and Meta-Analyses-guided systematic review of PubMed/MEDLINE, Ovid Embase, and the Cochrane Central Register of Controlled Trials was conducted (to March 19, 2020), supplemented with Google Scholar, Plastic and Reconstructive Surgery, and The Journal of Hand Surgery. Two reviewers independently completed the primary and secondary screens and the quality appraisal. This study reviewed 577 abstracts and included 19 studies. Risk factors for aromatase inhibitor-induced carpal tunnel syndrome or stenosing

Transthyretin Cardiac Amyloidosis Evaluation and Management: 2025 ACC Concise Clinical Guidance.

Writing Committee, Kittleson MM, Ambardekar AV, Cheng RK, Griffin JM, Maurer MS · Journal of the American College of Cardiology · 2026

Transthyretin amyloid cardiomyopathy has emerged as an increasingly recognized cause of heart failure, particularly in older individuals. There is now greater awareness of transthyretin amyloid cardiomyopathy as an underlying etiology of heart failure, particularly in individuals with musculoskeletal manifestations such as bilateral carpal tunnel syndrome or spinal stenosis. There have also been substantial advances in diagnosis, including the ability to perform accurate noninvasive diagnosis using radionuclide scintigraphy in individuals with a negative monoclonal protein screen. Finally, individuals with transthyretin amyloid cardiomyopathy have benefitted from advances in broadly effective heart failure therapies, namely mineralocorticoid receptor antagonists and sodium glucose-cotransporter 2 inhibitors, as well as specific disease-modifying therapies with transthyretin stabilizers, tafamidis and acoramidis, and the transthyretin silencer vutrisiran. The purpose of this Concise Cli

[Expert Consensus Recommendations for the Diagnosis of Hereditary Transthyretin Amyloidosis with Polyneuropathy (hATTR-PN) in Chile].

Bevilacqua JA, Matamala JM, Zamorano I, Hernández Ú, Acosta I, Jurado F · Revista medica de Chile · 2026

Hereditary transthyretin amyloidosis is an autosomal dominant disease caused by mutations in the TTR gene, which encodes the protein transthyretin. It is characterized by the deposit of mutated transthyretin in multiple organs and systems, mainly the heart and peripheral nervous system, causing different forms of polyneuropathy. It is a progressive, disabling and fatal disease. Early diagnosis of hereditary amyloidosis, including amyloidotic neuropathy, is currently relevant, as there are specific treatments that modify the natural course of the disease. The purpose of this consensus is to provide recommendations for Chile, based on scientific evidence, which facilitate the suspicion and early diagnosis of familial amyloidosis, focused on those patients who present with neuropathy as the initial manifestation, to facilitate the timely treatment of affected patients. A recommendation was developed by consensus through the Delphi method by eight Chilean neurologists specialized in neurom

Hand Pain and Sensory Deficits: Carpal Tunnel Syndrome: Revision 2026.

Erickson M, Lawrence M, Lazinski MJ, Scott K, Martin RL · The Journal of orthopaedic and sports physical therapy · 2026

APTA Orthopedics and APTA Hand and Upper Extremity Physical Therapy, Academies of the American Physical Therapy Association, have an ongoing effort to create evidence-based clinical practice guidelines (CPGs) for physical therapy management and prevention of upper extremity musculoskeletal impairments described in the World Health Organization's International Classification of Functioning, Disability and Health (ICF). This particular guideline is a revision of the 2019 CPG that focuses on hand pain and sensory deficits in carpal tunnel syndrome. J Orthop Sports Phys Ther 2026;56(4):CPG1-CPG79. Epub 12 February 2026. doi:10.2519/jospt.2026.0301.

Effects of electroacupuncture on carpal tunnel syndrome: a clinical, electrophysiological and ultrasonographical pilot study.

Ntoutsouli AM, Georgoudis G, Papapostolou A, Karavis M, Petrou DD, Vadalouca A · Acupuncture in medicine : journal of the British Medical Acupuncture Society · 2025 · n=12

Carpal tunnel syndrome (CTS) is the most common compressive neuropathy and is associated with significant strain on both patients and healthcare systems. Acupuncture is one of the conservative treatments used for this syndrome, although more evidence is needed regarding the efficacy of this intervention. The aim of this pilot study was to evaluate the effects of electroacupuncture (EA) in patients with CTS through clinical, electrophysiological and ultrasonographical assessments. Seventeen wrists, belonging to a total of 12 patients who had been diagnosed with CTS, were included. Eight EA sessions were performed (twice a week for 4 weeks). The visual analogue scale (VAS), symptom severity scale (SSS) and functional status scale (FSS) of the Boston Carpal Tunnel Questionnaire (BCTQ) were administered, median nerve conduction studies were performed and the cross-sectional area (CSA) of the median nerve was measured by ultrasound. These evaluations were made at baseline and 3-7&#x

The effects of virtual reality-mediated tendon and nerve gliding exercises in the conservative management of carpal tunnel syndrome: a double-blind randomized placebo controlled trial.

Arman S, Menekseoglu AK, Sezgin B, Ozgur B, Capan N, Oral A · European journal of physical and rehabilitation medicine · 2024 · n=33

Carpal tunnel syndrome (CTS) is a common condition resulting from compression of the median nerve at the wrist. First-line treatment typically involves conservative management, which commonly includes splinting and gliding exercises. Emerging evidence suggests the potential benefits of using virtual reality (VR) in rehabilitation. This study aimed to assess the effects of VR-mediated tendon and nerve gliding exercises on the conservative treatment of CTS, compared to video-assisted (sham virtual) and home-based gliding exercises. This study was a prospective, double-blind, randomized, placebo controlled interventional trial. The study was conducted in the Department of Physical Medicine and Rehabilitation at a university hospital. The study included patients with mild to moderate CTS. The study included a total of 54 hands from 33 patients. The participants were randomly allocated into three groups: the VR-mediated group (VG), the sham VR-mediated group (SG), and the control (home

Volume Effect of Nerve Hydrodissection for Carpal Tunnel Syndrome: A Prospective, Randomized, and Single-Blind Study.

Huang CY, Lai CY, Reeves KD, Lam KHS, Li TY, Cheng CI · Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine · 2024

This study compared ultrasound-guided nerve hydrodissection (HD) outcomes using two commonly used injectate volumes (10 and 5 mL) of normal saline to explore if there is a volume effect of HD for patients with moderate carpal tunnel syndrome (CTS). Twenty-four participants were randomly assigned to treatment with HD using ultrasound-guidance and either 10 mL or 5 mL of normal saline (HD-10 and HD-5 groups respectively). Our primary outcome measures were the change scores of the two subscales of the Boston Carpal Tunnel Syndrome Questionnaire: The Symptom Severity Scale (SSS) and Functional Status Scale (FSS). We conducted a one-way repeated analysis of variance for 3 time points (4, 12, and 24 weeks) for both SSS and FSS, respectively, for change scores from time 0, and percentage change from time 0. All participants (n = 12 per group) completed the study. From 0 to 24 weeks the HD-10 group outperformed the HD-5 group for improvement i

Acromegaly diagnosis.

Yogi-Morren D, Chanson P · The Journal of clinical endocrinology and metabolism · 2026

The clinical presentation of acromegaly reflects systemic effects of chronic growth hormone (GH) and insulin-like growth factor 1 (IGF-I) excess. Diagnostic delay frequently ranges from 6 to 10 years. While classical manifestations such as acral enlargement and facial coarsening are diagnostically important, many patients initially develop nonspecific symptoms, including sleep apnea, carpal tunnel syndrome, arthralgia, and metabolic disturbances. The lack of symptom/comorbidity specificity highlights the need for improved screening strategies, particularly for patients without overt acral changes. Comorbidity cluster analyses, potentially supported by artificial intelligence, may facilitate earlier identification, prompting biochemical confirmation of the diagnosis. Biochemical evaluation has benefited from advances in hormone assay harmonization and the establishment of robust age-adjusted reference ranges. Serum IGF-I is the preferred initial screening test due to its stability and r

Understanding degenerative cervical myelopathy in musculoskeletal practice.

Cervellini M, Feller D, Maselli F, Rossettini G, Cook C, Tabrah J · The Journal of manual & manipulative therapy · 2025

Degenerative cervical myelopathy (DCM) is a clinical syndrome characterized by a progressive compression of the spinal cord. DCM often looks like common symptoms of aging or bilateral carpal tunnel syndrome in its early stages, requiring careful differential diagnosis. Identifying DCM is a real challenge as no validated screening tools are available for making the DCM diagnosis. Potentially, individuals with DCM may experience misdiagnosis or substantial diagnostic delays, with an enhanced risk of irreversible neurological consequences if not promptly addressed. Despite the increasing prevalence, there is a lack of awareness about DCM among both the public and healthcare professionals. However, patients may seek physiotherapy to obtain a diagnosis or access treatment. A comprehensive (non-systematic) review of the literature about DCM epidemiology, pathophysiology, clinical presentation, diagnostic methods, and management was conducted. A guide and essential knowledge to facilitate c

Unraveling the causality between carpal tunnel syndrome and trigger finger through genetic instrumental variables.

Huang J, Deng K, Huang S, Lv Z, Zhou S, Chen M · European journal of medical research · 2025

Carpal tunnel syndrome (CTS) and trigger finger (TF) are the two most common non-traumatic connective tissue disorders of the hands. These conditions often manifest concurrently in certain patients; however, the mechanisms underlying this phenotypic association remain inadequately understood. In this study, we aimed to systematically investigate the causal relationship between CTS and TF using a large sample size and advanced methods. In this study, comprehensive summary-level data on CTS and TF from genome-wide association studies (GWAS) were collected. The causal relationship between CTS and TF was investigated using two-sample Mendelian randomization (MR). Sensitivity analyses were conducted to evaluate the robustness of MR findings. Furthermore, multivariable Mendelian randomization (MVMR) was employed to examine the role of CTS in causation and adjust for potential confounding variables. Additionally, supplementary reverse MR analysis was performed to ascertain the causal effect

Carpal Tunnel Syndrome (search results)

NCCIH

The National Center for Complementary and Integrative Health provides information and research on complementary health approaches for various conditions, including search results relevant to carpal tunnel syndrome. It offers evidence-based insights into alternative therapies.

The Long-term Effect of Platelet-rich Plasma in Patients With Carpal Tunnel Syndrome: a Prospective Randomized Double-blind Controlled Trial

n=26 · NCT03184688 · COMPLETED · COMPLETED

Carpal tunnel syndrome (CTS) is the most common peripheral entrapment neuropathy with involving compression of the median nerve in the carpal tunnel. Although many conservative managements of CTS, the effectiveness of these methods is insignificant or only persist for a short duration. The platelet rich plasma (PRP) is a new and potential treatment for patients with kinds of musculoskeletal disorders and recent reports showed being beneficial for peripheral neuropathy in animal studies. Since 2014, four small clinical trials showed the positive effect of PRP in peripheral neuropathy. Among these studies, two small trials showed beneficial effect of PRP for patients with mild CTS. However, the definite clinical effect of PRP for peripheral neuropathy from currently published studies is unclarified because these studies enrolled a few patients and lacked long-term follow-up (no more than 6 months follow-up).

Evaluation of the Efficacy of High Intensity Laser (HILT) Therapy in Idiopathic Carpal Tunnel Syndrome

n=60 · NCT04949373 · COMPLETED · COMPLETED

This research aims to investigate the effect of high-intensity laser therapy on pain, function, nerve conduction studies and grip strength in patients with idiopathic carpal tunnel syndrome.

Carpal Tunnel Syndrome: Case Reports and Analysis - Ultrasound Imaging and Pathomechanics of Median Nerve Compression

n=4 · NCT00987571 · COMPLETED · COMPLETED

Carpal tunnel syndrome is caused by compression of the median nerve at the wrist. The hypothesis is that ultrasound imaging can be used to visualize nerve compression in carpal tunnel patients during hand activity, and normal subjects will not demonstrate any nerve compression.

TRIP Database: Carpal Tunnel Syndrome

TRIP Database

TRIP Database offers a federated search across multiple evidence sources for carpal tunnel syndrome, including clinical guidelines, systematic reviews, and primary research.

Cochrane reviews on carpal tunnel syndrome

Cochrane

Cochrane provides systematic reviews of primary research in human health care and health policy. This resource offers numerous evidence-based reviews related to various interventions for carpal tunnel syndrome.

TRIP Database search results for Carpal Tunnel Syndrome

TRIP Database

TRIP Database is a clinical search engine designed to allow users to quickly and easily find high-quality research evidence to support their practice. It aggregates evidence from multiple sources for carpal tunnel syndrome.