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.


METHODS
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."


METHODS
Reports involving either conservative or non-conservative treatment for CTS or original descriptive reports of surgical techniques of carpal tunnel release.


METHODS
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.


RESULTS
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.
Davis
P T
PT
Wolfe-Harris Center for Clinical Studies, Northwestern College of Chiropractic, Bloomington, MN 55431, USA.
Hulbert
J R
JR
D002349:Carpal Tunnel Syndrome / Q000209:etiology / Q000601:surgery* / Q000628:therapy*; D002684:Chiropractic / Q000379:methods; D006801:Humans; D012017:Referral and Consultation; D012307:Risk Factors