Highlights
- •Rigorous guidelines strongly support 6 treatments for CTS.
- •Fifteen of 48 conservative treatments for CTS were conditionally supported.
- •Pharmaceuticals/supplements and alternative treatments were not supported for CTS.
- •Information on effective dosages and concomitant treatments in CTS care is limited.
Abstract
Carpal tunnel syndrome (CTS) treatment contains ambiguities across and within disciplines.
This meta-synthesis of professional guidelines consolidates clinical treatment recommendations
for CTS treatment and classifies them by strength of evidence. We conducted a search
of Google, Google Scholar, and PubMed for published clinical treatment recommendations
for CTS. A systematic hand search was completed to identify additional professional
organizations with published recommendations. We extracted any mentioned treatment
from all sources but developed our final consolidated clinical treatment recommendations
only from select rigorous guidelines based on the Institute of Medicine (IOM) criteria
for trustworthy guidelines. We translated rating systems of the primary guidelines
into a universal rating system to classify recommendations for consolidated clinical
treatment recommendations. Our search yielded 30 sources that mentioned a total of
55 CTS treatments. Six of the sources met the IOM inclusion criteria. These primary
guidelines provided recommendations for 46 of the 55 treatments, which were consolidated
into 12 broad treatment categories. Surgery, positioning, and steroids were strongly
supported. Conservative treatments provided by rehabilitation professionals were conditionally
supported. Pharmaceuticals, supplements, and alternative treatments were not generally
supported. CTS is a complex condition with a wide variety of treatments provided by
a multitude of disciplines. Our consolidated clinical treatment recommendations offer
a comprehensive outline of available treatments for CTS and contributes to the process
of developing best practices for its treatment.
Keywords
List of abbreviations:
CTS (carpal tunnel syndrome), IOM (Institute of Medicine), NEATS (National Guideline Clearinghouse Extent of Adherence to Trustworthy Standards)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: April 28, 2021
Accepted:
March 27,
2021
Received in revised form:
February 26,
2021
Received:
September 24,
2020
Footnotes
Disclosures: none.
Identification
Copyright
© 2021 The American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
