Carpal tunnel syndrome: Conservative and nonconservative treatment. A chiropractic physician's perspective

Objective: To discuss the treatment of carpal tunnel syndrome (CTS) including indications for referral to medical evaluation and/or comanagement. Data Source: More than 200 articles published in the health care literature from 1963 to 1997 and indexed on Medline concerning conservative and surgical intervention for CTS. Indexing terms used were "Carpal Tunnel," combined with keywords "Conservative" and "Surgery." Study Selection: Reports involving either conservative or nonconservative treatment for CTS or original descriptive reports of surgical techniques of carpal tunnel release. Data Extraction: Indications and contraindications for each conservative and surgical option. Concise and general descriptions of manual, medical and surgical interventions in current use, including summaries of the benefits and risks of each treatment. Data Synthesis: The review is presented as a discussion of diagnostic technique and conservative and surgical treatments for CTS currently used in North America. Conclusions: Recommendations are that CTS, accompanied by demyelination but without axonal degeneration, can be treated initially with conservative medical or manual procedures.