Long-Term Outcomes of Non-surgical versus Surgical Treatment for Carpal Tunnel Syndrome: An Observational Cohort Study
Main Article Content
Abstract
Background: Carpal Tunnel Syndrome (CTS) is a common condition that significantly impacts patients' quality of life and work productivity. While both non-surgical and surgical treatments are employed, there is a lack of consensus regarding the most effective management strategy.
Objective: This study aims to compare the outcomes of non-surgical and surgical treatments for CTS, focusing on symptom severity, functional status, and patient satisfaction.
Methods: This observational cohort study included 74 participants, with 37 in each treatment group (non-surgical and surgical). Demographic data, including age, gender, occupation, and hand dominance, were recorded. Clinical parameters assessed were duration and severity of CTS symptoms, previous treatments, and comorbid conditions. The non-surgical group underwent treatments like wrist splinting, NSAIDs, and physical therapy, while the surgical group underwent decompression surgery. Outcomes measured included frequency and severity of symptoms, impact on daily activities, and satisfaction with treatment outcomes. Data were analysed using descriptive statistics to compare between groups.
Results: The average age was 50 ± 9 years in the non-surgical group and 52 ± 8 years in the surgical group, with a predominance of females in both. The non-surgical group showed higher frequency and severity of symptoms, with daily symptoms reported by 76.1% of patients, compared to 44.4% in the surgical group. Severity of pain was higher in the non-surgical group (5.8 out of 10) than in the surgical group (2.8 out of 10). Satisfaction with surgical outcomes was high, with all patients in the surgical group reporting satisfaction despite a 100% rate of postoperative complications.
Conclusion: The study indicates that surgical treatment for CTS may be more effective in reducing symptom severity and improving patient satisfaction compared to non-surgical methods. However, the high rate of postoperative complications in the surgical group necessitates careful consideration and patient counselling regarding treatment choices.
Keywords: Carpal Tunnel Syndrome, Non-surgical Treatment, Surgical Treatment, Patient Outcomes, Symptom Severity, Treatment Satisfaction
Article Details
![Creative Commons License](http://i.creativecommons.org/l/by/4.0/88x31.png)
This work is licensed under a Creative Commons Attribution 4.0 International License.
References
Verdugo RJ, Salinas RS, Castillo J, Cea JG. Surgical versus non-surgical treatment for carpal tunnel syndrome. The Cochrane database of systematic reviews. 2002(2):Cd001552.
O'Connor D, Page MJ, Marshall SC, Massy-Westropp N. Ergonomic positioning or equipment for treating carpal tunnel syndrome. The Cochrane database of systematic reviews. 2012;1(1):Cd009600.
Page MJ, Massy-Westropp N, O'Connor D, Pitt V. Splinting for carpal tunnel syndrome. The Cochrane database of systematic reviews. 2012;2012(7):Cd010003.
Page MJ, O'Connor D, Pitt V, Massy-Westropp N. Therapeutic ultrasound for carpal tunnel syndrome. The Cochrane database of systematic reviews. 2012;1:Cd009601.
Rankin IA, Sargeant H, Rehman H, Gurusamy KS. Low-level laser therapy for carpal tunnel syndrome. The Cochrane database of systematic reviews. 2017;8(8):Cd012765.
Ashworth NL, Bland JDP, Chapman KM, Tardif G, Albarqouni L, Nagendran A. Local corticosteroid injection versus placebo for carpal tunnel syndrome. The Cochrane database of systematic reviews. 2023;2(2):Cd015148.
Karjalainen TV, Lusa V, Page MJ, O'Connor D, Massy-Westropp N, Peters SE. Splinting for carpal tunnel syndrome. The Cochrane database of systematic reviews. 2023;2(2):Cd010003.
Moro-López-Menchero P, García-Bravo C, Fernández-de-Las-Peñas C, Güeita-Rodríguez J, Jiménez-Antona C, Palacios-Ceña D. Understanding the Non-Surgical Treatment Experience of Female Patients with Carpal Tunnel Syndrome: A Qualitative Study. International journal of environmental research and public health. 2022;19(19):12349.
Shi Q, Bobos P, Lalone EA, Warren L, MacDermid JC. Comparison of the short-term and long-term effects of surgery and nonsurgical intervention in treating carpal tunnel syndrome: a systematic review and meta-analysis. Hand. 2020;15(1):13-22.
Jones NF. Discussion: Outcomes of Carpal Tunnel Release in Complex Regional Pain Syndrome/Reflex Sympathetic Dystrophy/Sudeck Disease Patients. Plastic and Reconstructive Surgery. 2022;150(1):102-3.
Omole AE, Awosika A, Khan A, Adabanya U, Anand N, Patel T, et al. An Integrated Review of Carpal Tunnel Syndrome: New Insights to an Old Problem. Cureus. 2023;15(6).
Martin-Vega FJ, Vinolo-Gil MJ, Gonzalez-Medina G, Rodríguez-Huguet M, Carmona-Barrientos I, García-Muñoz C. Use of Iontophoresis with Corticosteroid in Carpal Tunnel Syndrome: Systematic Review and Meta-Analysis. International journal of environmental research and public health. 2023;20(5):4287.
Boyd KU, Gan BS, Ross DC, Richards RS. Outcomes in carpal tunnel syndrome: symptom severity, conservative management and progression to surgery. Clinical and investigative medicine. 2005;28(5):254.
Kiylioglu N, Bicerol B, Ozkul A, Akyol A. Natural course and treatment efficacy: one-year observation in diabetic and idiopathic carpal tunnel syndrome. Journal of Clinical Neurophysiology. 2009;26(6):446-53.
Hall B, Lee HC, Fitzgerald H, Byrne B, Barton A, Lee AH. Investigating the effectiveness of full-time wrist splinting and education in the treatment of carpal tunnel syndrome: a randomized controlled trial. The American Journal of Occupational Therapy. 2013;67(4):448-59.
Claes F, Kasius KM, Meulstee J, Grotenhuis JA, Verhagen WI. Treatment outcome in carpal tunnel syndrome: does distribution of sensory symptoms matter? Journal of the Neurological Sciences. 2014;344(1-2):143-8.
Jerosch-Herold C, Shepstone L, Wilson EC, Dyer T, Blake J. Clinical course, costs and predictive factors for response to treatment in carpal tunnel syndrome: the PALMS study protocol. BMC musculoskeletal disorders. 2014;15(1):1-7.
Ren Y-M, Wang X-S, Wei Z-J, Fan B-Y, Lin W, Zhou X-H, et al. Efficacy, safety, and cost of surgical versus nonsurgical treatment for carpal tunnel syndrome: a systematic review and meta-analysis. Medicine. 2016;95(40).
Farioli A, Curti S, Bonfiglioli R, Baldasseroni A, Spatari G, Mattioli S, et al. Observed differences between males and females in surgically treated carpal tunnel syndrome among non-manual workers: a sensitivity analysis of findings from a large population study. Annals of work exposures and health. 2018;62(4):505-15.
Klokkari D, Mamais I. Effectiveness of surgical versus conservative treatment for carpal tunnel syndrome: A systematic review, meta-analysis and qualitative analysis. Hong Kong Physiotherapy Journal. 2018;38(02):91-114.
Kogut K, Glinkowski WM. Patient-reported outcomes of carpal tunnel syndrome surgery in a non-industrial area. Annals of Agricultural and Environmental Medicine. 2019;26(2).
Sears ED, Meerwijk EL, Schmidt EM, Kerr EA, Chung KC, Kamal RN, et al. Variation in nonsurgical services for carpal tunnel syndrome across a large integrated health care system. The Journal of hand surgery. 2019;44(2):85-92. e1.
Tahir M, Tehzeeb K, Javaid F, Khan UA, Ayyaz A, Usama M. EFFECTS OF ROUTINE PHYSICAL THERAPY WITH AND WITHOUT HIGH INTENSITY INTERVAL TRAINING ON BALANCE, QUALITY OF LIFE AND FUNCTION IN PARKINSON’S DISEASE PATIENTS. Journal of Population Therapeutics and Clinical Pharmacology. 2023;30(19):483-90.
Fernández-de-Las-Peñas C, Arias-Buría JL, Cleland JA, Pareja JA, Plaza-Manzano G, Ortega-Santiago R. Manual therapy versus surgery for carpal tunnel syndrome: 4-year follow-up from a randomized controlled trial. Physical therapy. 2020;100(11):1987-96.
Kastilong MP, Winifred K, Sekeon SA. Quality of life of carpal tunnel syndrome with non operative treatment: cohort study. International Journal of Research in Medical Sciences. 2020;8(7):2502.
Risstad H, Espeland AL, Evensen L, Berthelsen A-L, Elvsaas I-KØ. Surgical Treatment of Carpal Tunnel Syndrome: A Health Technology Assessment. 2021.
Ly-Pen D, Andreu JL, Millán I, de Blas G, Sánchez-Olaso A. Long-term outcome of local steroid injections versus surgery in carpal tunnel syndrome: observational extension of a randomized clinical trial. Hand. 2022;17(4):639-45.
Burton C, Rathod-Mistry T, Blackburn S, Blagojevic-Bucknall M, Chesterton L, Davenport G, et al. The effectiveness of corticosteroid injection versus night splints for carpal tunnel syndrome: 24-month follow-up of a randomized trial. Rheumatology. 2023;62(2):546-54.