Abstract
Objective
To achieve consensus on a multidisciplinary treatment guideline for carpal tunnel
syndrome (CTS).
Design
Delphi consensus strategy.
Setting
Systematic reviews reporting on the effectiveness of surgical and nonsurgical interventions
were conducted and used as an evidence-based starting point for a European Delphi
consensus strategy.
Participants
In total, 35 experts (hand surgeons selected from the Federation of European Societies
for Surgery of the Hand, hand therapists selected from the European Federation of
Societies for Hand Therapy, physical medicine and rehabilitation physicians) participated
in the Delphi consensus strategy.
Interventions
Not applicable.
Main Outcome Measures
Each Delphi round consisted of a questionnaire, analysis, and feedback report.
Results
After 3 Delphi rounds, consensus was achieved on the description, symptoms, and diagnosis
of CTS. The experts agreed that patients with CTS should always be instructed, and
instructions combined with splinting, corticosteroid injection, corticosteroid injections
plus splinting, and surgery are suitable treatments for CTS. Relevant details for
the use of instructions, splinting, corticosteroid injections, and surgery were described.
Main factors for selecting one of the aforementioned treatment options were identified
as follows: severity and duration of the disorder and previous treatments received.
A relation between the severity/duration and choice of therapy was found by the experts
and reported in the guideline.
Conclusions
This multidisciplinary treatment guideline may help physicians and allied health care
professionals to provide patients with CTS with the most effective and efficient treatment
available.
Keywords
List of abbreviations:
CTS (carpal tunnel syndrome), EFSHT (European Federation of Societies for Hand Therapy), FESSH (Federation of European Societies for Surgery of the Hand), IC (instructions plus corticosteroid injection), ICS (instructions plus corticosteroid injections plus splinting), IO (instructions plus operative treatment/surgery), IS (instructions plus splinting), NSAID (nonsteroidal anti-inflammatory drug), PM&R (physical medicine and rehabilitation)To read this article in full you will need to make a payment
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Article Info
Publication History
Published online: August 12, 2014
Footnotes
Supported by Fonds NutsOhra (grant no. FNO 0804 ).
Disclosures: none.
Identification
Copyright
© 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
