g Text Version
Beauty & Self
Books & Music
Food & Wine
Health & Fitness
Hobbies & Crafts
Home & Garden
News & Politics
Religion & Spirituality
Travel & Culture
TV & Movies

Bored? Games!
Take a Quiz
Rate My Photo

Natural Living
Folklore and Mythology
Distance Learning

All times in EST

Full Schedule
g Ergonomics Site

BellaOnline's Ergonomics Editor


Carpal Tunnel Syndrome Treatment Guidelines

Guest Author - Marji Hajic

On October 27, 2008, the American Academy of Orthopaedic Surgeons (AAOS) released guidelines for the treatment of carpal tunnel syndrome.

Carpal Tunnel Syndrome (CTS) is one of the most common disorders of the upper extremity affecting up to 10% of the population. According to the National Center for Health Statistics an estimated 3.1 million people sought help from physicians for the treatment of CTS (2005).  “In June 2007, the Journal of the Academy of Orthopaedic Surgeons (JAAOS) reported about 500,000 CTS surgical procedures are performed each year. The same study also reported the economic impact due to CTS is estimated to exceed $2 billion annually.”

The CTS patient care guidelines were written to help physicians improve their care for those suffering from CTS.  Nine treatment recommendations were made that include both operative and non-operative treatment options as well as alternative treatment techniques.  The effectiveness of these treatments was evaluated based upon evidence reviewed from studies in medical literature. 

Within the guidelines, non-operative treatment is initially recommended.  Effective treatments may include splinting or bracing of the wrist, ultrasound, cortisone injections into the carpal tunnel or a course of oral steroids.  If treatment does not produce relief within two to seven weeks, a different treatment or a carpal tunnel release surgery may be indicated.

Surprisingly, the following treatments were inconclusive for effectiveness in resolving carpal tunnel syndrome symptoms: activity modifications, acupuncture, cold laser, diuretics, exercise, electric stimulation, fitness, stretching, massage therapy, magnet therapy, manipulation, medications (including anticonvulsants, antidepressants and NSAIDs), nutritional supplements, smoking cessation, systemic steroid injection, therapeutic touch, vitamin B6 (pyridoxine), weight reduction, or yoga.

A word of caution is given by AAOS: there was not enough evidence to provide specific treatment recommendations for carpal tunnel syndrome when found in association with the following conditions: diabetes mellitus, coexistent cervical radiculopathy, hypothyroidism, polyneuropathy, pregnancy, rheumatoid arthritis, and carpal tunnel syndrome in the workplace.

As a therapist, I know that we sometimes take a shotgun approach to treatment and provide many of the treatments listed above.  I applaud the AAOS for taking a systematic approach to assessing the effectiveness of the individual treatments that we use.  However, I also know that people get better with therapy.  I am currently working with one woman who was in tears because of the pain.  She was not only struggling to work, but had given up sports and leisure activities, hobbies and crafts, and even housework.  During the 4 weeks it took to get treatment authorized, her symptoms got worse.  Almost immediately upon beginning therapy, her symptoms improved.  Because of her level of pain, I used threw everything in my arsenal at her: heat, ultrasound, cold laser, electrical stimulation, stretches and exercises (gentle), manual therapy and massage, and education in positioning and ergonomics.  Sure, I can’t pinpoint exactly which treatment was the most effective.  Likely, it is a combination of everything.  So, in spite of the guidelines, I’ll keep using the tools that I have.  Every body responds differently.  Every situation is unique.  I only hope that these guidelines will be used as just that and not as a way for insurances to deny treatment.

AAOS Clinical Guidelines on the Treatment of Carpal Tunnel Syndrome - Summary

American Academy Of Orthopaedic Surgeons Clinical Practice Guideline On The Treatment Of Carpal Tunnel Syndrome – complete 84 page guideline document
Marji Hajic is an Occupational Therapist and a Certified Hand Therapist practicing at the Hand Therapy & Occupational Fitness Center in Santa Barbara, California. For more information on hand and upper extremity injuries, prevention and recovery, visit Hand Health Resources.

This site needs an editor - click to learn more!

Add Carpal+Tunnel+Syndrome+Treatment+Guidelines to Twitter Add Carpal+Tunnel+Syndrome+Treatment+Guidelines to Facebook Add Carpal+Tunnel+Syndrome+Treatment+Guidelines to MySpace Add Carpal+Tunnel+Syndrome+Treatment+Guidelines to Digg Carpal+Tunnel+Syndrome+Treatment+Guidelines Add Carpal+Tunnel+Syndrome+Treatment+Guidelines to Yahoo My Web Add Carpal+Tunnel+Syndrome+Treatment+Guidelines to Google Bookmarks Add Carpal+Tunnel+Syndrome+Treatment+Guidelines to Stumbleupon Add Carpal+Tunnel+Syndrome+Treatment+Guidelines to Reddit

Carpal Tunnel Syndrome - Back to the Basics
Carpal Tunnel Syndrome ABCs
Cubital Tunnel Syndrome - Carpal Tunnel's Counterpart
Related Articles
Editor's Picks Articles
Top Ten Articles
Previous Features
Site Map

For FREE email updates, subscribe to the Ergonomics Newsletter

Past Issues

Printer Friendly
tell friend
Tell a Friend
Email Editor

Content copyright © 2018 by Marji Hajic. All rights reserved.
This content was written by Marji Hajic. If you wish to use this content in any manner, you need written permission. Contact BellaOnline Administration for details.


g features
Wraptastic Product Review

Dragon Naturally Speaking - Voice Recognition

DeQuervain's Tenosynovitis-Thumb and Wrist Pain

Archives | Site Map


Past Issues

Note: BellaOnline uses cookies to help provide a consistent user experience. Our advertisers may use cookies to help customize ads. Please contact us with any question about our cookie use.

Summertime Foods
Corn on the Cob
Burgers on the Grill
Apple Pie


| About BellaOnline | Privacy Policy | Advertising | Become an Editor |
Website copyright © 2018 Minerva WebWorks LLC. All rights reserved.

BellaOnline Editor