Non‐surgical treatment (other than steroid injection) for carpal tunnel syndrome

摘要: Background Non-surgical treatment for carpal tunnel syndrome is frequently offered to those with mild moderate symptoms. The effectiveness and duration of benefit from non-surgical remain unknown. Objectives To evaluate the (other than steroid injection) versus a placebo or other non-surgical, control interventions in improving clinical outcome. Search methods We searched Cochrane Neuromuscular Disease Group specialised register (searched March 2002), MEDLINE January 1966 February 7 2001), EMBASE 1980 CINAHL 1983 December AMED 1984 Current Contents (January 1993 PEDro reference lists articles. Selection criteria Randomised quasi-randomised studies any language participants diagnosis who had not previously undergone surgical release. We considered all treatments apart local injection. primary outcome measure was improvement symptoms after at least three months following end treatment. Data collection analysis Three reviewers independently selected trials be included. Two extracted data. Studies were rated their overall quality. Relative risks weighted mean differences 95% confidence intervals calculated secondary outcomes each trial. Results clinically statistically homogeneous pooled provide estimates efficacy treatments. Main results Twenty-one involving 884 people A hand brace significantly improved four weeks (weighted difference (WMD) -1.07; interval (CI) -1.29 -0.85) function (WMD -0.55; CI -0.82 -0.28). In an analysis data two (63 participants) ultrasound beneficial. However one trial showed significant symptom seven -0.99; -1.77 - 0.21) which maintained six -1.86; -2.67 -1.05). Four 193 examined various oral medications (steroids, diuretics, nonsteroidal anti-inflammatory drugs) placebo. Compared placebo, two-week demonstrated -7.23; -10.31 -4.14). One also -10.8; -15.26 -6.34). diuretics drugs did demonstrate benefit. 50 people, vitamin B6 improve 51 yoga reduced pain eight -1.40; -2.73 -0.07) compared wrist splinting. 21 bone mobilisation -1.43; -2.19 -0.67) no treatment. diabetes, insulin injections over injections. 105 ergonomic keyboards equivocal results function. Trials magnet therapy, laser acupuncture, exercise chiropractic care when control. Authors' conclusions Current evidence shows short-term steroids, splinting, ultrasound, mobilisation. Other do produce More are needed compare ascertain