Which treatments for carpal tunnel syndrome?

Researchers from Catholic University in Washington, DC searched the literature for treatments of carpal tunnel syndrome.

33 published studies were reviewed.

There is?

• Strong evidence (level I) for the effectiveness of local and oral steroids.
• Moderate evidence (level II) that splints are effective.
• Moderate evidence (level II) that vitamin B6 is ineffective.
• Limited or conflicting evidence (level III) that nonsteroidal anti-inflammatory drugs (NSAIDs), diuretics, yoga, laser and ultrasound are effective.
• Limited or conflicting evidence (level III) that exercise therapy and botulinum toxin B injection are ineffective.

For future reference, here’s the U.S. Preventive Services Task Force system for ranking evidence about the effectiveness of treatments.

• Level I: Evidence obtained from at least one properly designed randomized controlled trial.
• Level II-1: Evidence obtained from well-designed controlled trials without randomization.
• Level II-2: Evidence obtained from well-designed cohort or case-control analytic studies, preferably from more than one center or research group.
• Level II-3: Evidence obtained from multiple time series with or without the intervention. Dramatic results in uncontrolled trials might also be regarded as this type of evidence.
• Level III: Opinions of respected authorities, based on clinical experience, descriptive studies, or reports of expert committees.

7/7/07