Table 3.

Possibly Effective Nonsurgical Treatments for Carpal Tunnel Syndrome

TreatmentInitial SuccessLong-Term SuccessEvidenceAdvantagesDisadvantages
RCT = randomized controlled trial; NNT = number needed to treat.
Laser-acupunctureReduction in night pain but not paraesthesiaUnknown1 poor-quality RCT14Possible preoperative analgesic agentPoor availability
Nerve and tendon gliding exercisesNo significant difference for Phalen’s or Tinel’s sign, or nerve conduction studiesSignificantly reduced rates of surgeryBefore-and-after study using historical controls26NoninvasiveReduced surgical rates may result from confounders
NNT = 4
UltrasoundOne study suggested improvement in both symptoms and nerve conduction studies19; other study found no significant difference25Unknown2 RCTs19,25NoninvasiveExpensive
Conflicting evidenceHigh dropout rate
Wrist splintingNeutral superior to 20o extension splintingUnknown1 systematic review35 plus 1 RCT19No harmful effects notedPoor compliance
Full-time use significantly greater improvement in nerve conduction studies but no difference in symptomsAll studies had methodological flaws
YogaSignificant improvement in Phalen’s sign, grip strength, and pain reduction but not Tinel’s sign, sleep disturbance, or nerve conduction studiesUnknownRCT (single-blind)21NoninvasiveNo changes in nerve conduction studies
Can be home-based treatment
Involves high level of patient commitment
Control group had wrist splinting.