CURRENT TREATMENT STRATEGIES FOR CARPAL TUNNEL SYNDROME. A LITERATURE REVIEW

Authors

DOI:

https://doi.org/10.31435/ijitss.3(51).2026.6159

Keywords:

Carpal Tunnel Syndrome, Carpal Tunnel Release, Carpal Tunnel Syndrome Treatment, Open Carpal Tunnel Release, Median Nerve Decompression

Abstract

Introduction: Carpal tunnel syndrome (CTS) is the most common peripheral nerve entrapment, which significantly affects patients’ quality of life. Recent reports revealed many new aspects of treatment. It is necessary to continuously improve diagnostic and therapeutic procedures.

Aim: The aim of this article is to review the latest research on CTS. The article briefly describes diagnostic methods, focusing primarily on conservative and surgical treatments used for CTS.

Material and methods: A literature review was conducted using the PubMed and Google Scholar databases. The focus was on studies published between 2016 and 2026.

Results: Objective diagnostic methods, such as electrodiagnostic studies (EDX), combined with clinical evaluation, are essential for selecting the appropriate treatment for CTS. Although previous studies on conservative treatment yielded inconsistent outcomes, its effectiveness has been demonstrated in the early stages of the disease. Surgical treatment proves more effective in more advanced cases. Both open and endoscopic surgical techniques yield comparable long-term results. However, less invasive methods result in less tissue damage and a faster recovery for the patient.

Conclusions: Effective treatment of CTS requires a thorough evaluation of the disease severity during the diagnostic phase. Conservative treatment plays a significant role in the early stages of CTS. However, surgical decompression of the median nerve remains the mainstay of causal treatment. Further standardized studies are needed to determine the best therapeutic strategies.

References

Aguila, D., Kirsch, M., Kindle, B., & Paterson, P. (2023). Long-Term Clinical Results of Carpal Tunnel Release Using Ultrasound Guidance: A Multicenter Pragmatic Study. Journal of Hand Surgery Global Online, 6(1), 79. https://doi.org/10.1016/J.JHSG.2023.10.001

Alanazy, M. H. (2017). Clinical and electrophysiological evaluation of carpal tunnel syndrome: approach and pitfalls. Neurosciences, 22(3), 169. https://doi.org/10.17712/NSJ.2017.3.20160638

Alrayes, M. S., Altawili, M., Alsaffar, M. H., Alfarhan, G. Z., Owedah, R. J., Bodal, I. S., Alshahrani, N. A. A., ASSIRI, A. A. M., & Sindi, A. W. (2024). Surgical Interventions for the Management of Carpal Tunnel Syndrome: A Narrative Review. Cureus, 16(3), e55593. https://doi.org/10.7759/CUREUS.55593

Ashworth, N. L., Bland, J. D. P., Chapman, K. M., Tardif, G., Albarqouni, L., & Nagendran, A. (2023). Local corticosteroid injection versus placebo for carpal tunnel syndrome. The Cochrane Database of Systematic Reviews, 2023(2), CD015148. https://doi.org/10.1002/14651858.CD015148

Bassil, G. F., Otayek, J., Moucharafieh, R. C., & Badra, M. (2024). A Comparison of Mini Open Transverse Incision and Longitudinal Incision for the Release of Moderate and Severe Carpal Tunnel Syndrome. Cureus, 16(3), e56677. https://doi.org/10.7759/CUREUS.56677

Bittencourt, J. V., Corrêa, L. A., Pagnez, M. A. M., do Rio, J. P. M., Telles, G. F., Mathieson, S., & Nogueira, L. A. C. (2024). Neural mobilisation effects in nerve function and nerve structure of patients with peripheral neuropathic pain: A systematic review with meta-analysis. PLOS ONE, 19(11), e0313025. https://doi.org/10.1371/JOURNAL.PONE.0313025

Cazares-Manríquez, M. A., Wilson, C. C., Vardasca, R., García-Alcaraz, J. L., Olguín-Tiznado, J. E., López-Barreras, J. A., & García-Rivera, B. R. (2020). A Review of Carpal Tunnel Syndrome and Its Association with Age, Body Mass Index, Cardiovascular Risk Factors, Hand Dominance, and Sex. Applied Sciences 2020, Vol. 10, Page 3488, 10(10), 3488. https://doi.org/10.3390/APP10103488

Dabbagh, A., MacDermid, J. C., Yong, J., Packham, T. L., Grewal, R., & Boutsikari, E. C. (2023). Diagnostic Test Accuracy of Provocative Maneuvers for the Diagnosis of Carpal Tunnel Syndrome: A Systematic Review and Meta-Analysis. Physical Therapy, 103(6), pzad029. https://doi.org/10.1093/PTJ/PZAD029

De Arenas-Arroyo, S. N., Cavero-Redondo, I., Torres-Costoso, A., Reina-Gutiérrez, S., José Guzmán-Pavón, M., & Martínez-Vizcaíno, V. (2022). Accuracy of the Most Common Provocation Tests for Diagnosing Carpal Tunnel Syndrome: A Systematic Review With Meta-analysis. The Journal of Orthopaedic and Sports Physical Therapy, 52(8), 522–531. https://doi.org/10.2519/JOSPT.2022.10828

Ðilvesi, Ð., Jelača, B., Kneževi´c, A. K., Živanovi´c, Ž. Ž., Panteli´cpanteli´c, V., & Golubovi´cgolubovi´c, J. (2026). Evolution of Carpal Tunnel Syndrome Treatment: A Narrative Review. NeuroSci 2026, Vol. 7, Page 10, 7(1), 10. https://doi.org/10.3390/NEUROSCI7010010

Dong, Y., Zhuang, Y., Li, L., Li, Y., & Dai, H. (2026). Carpal Tunnel Syndrome Diagnosis: A Narrative Review of Complementary Roles of Neuromuscular Ultrasound and Electrodiagnostic Studies. Medical Science Monitor, 32, e952034. https://doi.org/10.12659/MSM.952034

Genova, A., Dix, O., Saefan, A., Thakur, M., & Hassan, A. (2020). Carpal Tunnel Syndrome: A Review of Literature. Cureus, 12(3), e7333. https://doi.org/10.7759/CUREUS.7333

Hidayati, H. B., Subadi, I., Fidiana, F., & Puspamaniar, V. A. (2022). Current diagnosis and management of carpal tunnel syndrome: A review. Anaesthesia, Pain & Intensive Care, 26(3), 394–404. https://doi.org/10.35975/apic.v26i3.1902

Hu, F., Lu, L., Zeng, J., Li, D., & Liu, B. (2022). Comparison of the Therapeutic Effect of the Mini-Open Incision and Conventional Open Neurolysis of the Median Nerve for Carpal Tunnel Syndrome. International Journal of Clinical Practice, 2022, 4082618. https://doi.org/10.1155/2022/4082618

Jiang, J., Xing, F., Luo, R., & Liu, M. (2022). Effectiveness of Platelet-Rich Plasma for Patients With Carpal Tunnel Syndrome: A Systematic Review and meta-Analysis of Current Evidence in Randomized Controlled Trials. Frontiers in Pharmacology, 13, 834213. https://doi.org/10.3389/FPHAR.2022.834213

Jones, Q., Hill, E. E., Li, A., Pereira, C., Dave, D., Robker, J., & Jones, N. F. (2024). Clinical, Electrophysiological, and Intraoperative Analysis and Postoperative Success of Revision Surgery for Persistent and Recurrent Carpal Tunnel Syndrome. Eplasty, 24, e56. https://pmc.ncbi.nlm.nih.gov/articles/PMC11520360/

Joshi, A., Patel, K., Mohamed, A., Oak, S., Zhang, M. H., Hsiung, H., Zhang, A., Patel, U. K., Joshi, A., Patel, K., Mohamed, A., Oak, S., Zhang, M. H., Hsiung, H., Zhang, A., & Patel, U. K. (2022). Carpal Tunnel Syndrome: Pathophysiology and Comprehensive Guidelines for Clinical Evaluation and Treatment. Cureus, 14(7). https://doi.org/10.7759/CUREUS.27053

Kaile, E., & Bland, J. D. P. (2018). Safety of corticosteroid injection for carpal tunnel syndrome. The Journal of Hand Surgery, European Volume, 43(3), 296–302. https://doi.org/10.1177/1753193417734426

Karaçorlu, F. N., Balgetir, F., Pirinçci, E., & Deveci, S. E. (2022). The relationship between carpal tunnel syndrome, smartphone use, and addiction: A cross-sectional study. Turkish Journal of Physical Medicine and Rehabilitation, 68(4), 517. https://doi.org/10.5606/TFTRD.2022.9365

Karjalainen, T. V., Lusa, V., Page, M. J., O’Connor, D., Massy-Westropp, N., & Peters, S. E. (2023). Splinting for carpal tunnel syndrome. The Cochrane Database of Systematic Reviews, 2023(2), CD010003. https://doi.org/10.1002/14651858.CD010003.PUB2

Kim, J. C., Jung, S. H., Lee, S. U., & Lee, S. Y. (2019). Effect of extracorporeal shockwave therapy on carpal tunnel syndrome: A systematic review and meta-analysis of randomized controlled trials. Medicine, 98(33), e16870. https://doi.org/10.1097/MD.0000000000016870

Klokkari, D., & Mamais, I. (2018). Effectiveness of surgical versus conservative treatment for carpal tunnel syndrome: A systematic review, meta-analysis and qualitative analysis. Hong Kong Physiotherapy Journal, 38(2), 91. https://doi.org/10.1142/S1013702518500087

Lai, S., Zhang, K., Li, J., & Fu, W. (2019). Carpal tunnel release with versus without flexor retinaculum reconstruction for carpal tunnel syndrome at short- and long-term follow up—A meta-analysis of randomized controlled trials. PLoS ONE, 14(1), e0211369. https://doi.org/10.1371/JOURNAL.PONE.0211369

Lam, K. H. S., Wu, Y. T., Reeves, K. D., Galluccio, F., Allam, A. E. S., & Peng, P. W. H. (2023). Ultrasound-Guided Interventions for Carpal Tunnel Syndrome: A Systematic Review and Meta-Analyses. Diagnostics, 13(6), 1138. https://doi.org/10.3390/DIAGNOSTICS13061138

Li, Z. J., Wang, Y., Zhang, H. F., Ma, X. L., Tian, P., & Huang, Y. (2016). Effectiveness of low-level laser on carpal tunnel syndrome: A meta-analysis of previously reported randomized trials. Medicine, 95(31), e4424. https://doi.org/10.1097/MD.0000000000004424

Li, Z. M., & Jordan, D. B. (2022). Carpal tunnel mechanics and its relevance to carpal tunnel syndrome. Human Movement Science, 87, 103044. https://doi.org/10.1016/J.HUMOV.2022.103044

Lin, C. P., Chang, K. V., Huang, Y. K., Wu, W. T., & Özçakar, L. (2020). Regenerative Injections Including 5% Dextrose and Platelet-Rich Plasma for the Treatment of Carpal Tunnel Syndrome: A Systematic Review and Network Meta-Analysis. Pharmaceuticals, 13(3), 49. https://doi.org/10.3390/PH13030049

Lusa, V., Karjalainen, T. V., Pääkkönen, M., Rajamäki, T. J., & Jaatinen, K. (2024). Surgical versus non‐surgical treatment for carpal tunnel syndrome. The Cochrane Database of Systematic Reviews, 2024(1), CD001552. https://doi.org/10.1002/14651858.CD001552.PUB3

Malakootian, M., Soveizi, M., Gholipour, A., & Oveisee, M. (2022). Pathophysiology, Diagnosis, Treatment, and Genetics of Carpal Tunnel Syndrome: A Review. Cellular and Molecular Neurobiology, 43(5), 1817. https://doi.org/10.1007/S10571-022-01297-2

Mujadzic, T., Friedman, H. I., Mujadzic, M. M., Gober, C., Chen, E., Atwez, A., Durkin, M., & Mujadzic, M. M. (2021). Modified Carpal Tunnel Release: A New Approach to Minimizing Pillar Pain. Annals of Plastic Surgery, 86(6S Suppl 5), S503–S509. https://doi.org/10.1097/SAP.0000000000002885

Ng, A. W. H., Griffith, J. F., Tong, C. S. L., Law, E. K. C., Tse, W. L., Wong, C. W. Y., & Ho, P. C. (2020). MRI criteria for diagnosis and predicting severity of carpal tunnel syndrome. Skeletal Radiology, 49(3), 397–405. https://doi.org/10.1007/S00256-019-03291-0

Osiak, K., Elnazir, P., Walocha, J. A., & Pasternak, A. (2022). Carpal tunnel syndrome: state-of-the-art review. Folia Morphologica, 81(4), 851–862. https://doi.org/10.5603/FM.A2021.0121

Page, M. J., O’Connor, D., Pitt, V., & Massy-Westropp, N. (2012). Exercise and mobilisation interventions for carpal tunnel syndrome. The Cochrane Database of Systematic Reviews, 2012(6). https://doi.org/10.1002/14651858.CD009899

Page, M. J., O’Connor, D., Pitt, V., & Massy-Westropp, N. (2013). Therapeutic ultrasound for carpal tunnel syndrome. The Cochrane Database of Systematic Reviews, 2013(3). https://doi.org/10.1002/14651858.CD009601.PUB2

Pimentel, B. F. R., Faloppa, F., Tamaoki, M. J. S., & Belloti, J. C. (2018). Effectiveness of ultrasonography and nerve conduction studies in the diagnosing of carpal tunnel syndrome: clinical trial on accuracy. BMC Musculoskeletal Disorders, 19(1), 115. https://doi.org/10.1186/S12891-018-2036-4

Rajapandian, R., Wala, S. M., Aledani, E. M., Samuel, E. A., Ahmad, K., Manongi, N. J., & Butt, S. R. (2024). Endoscopic Versus Open Carpal Tunnel Release: A Systematic Review of Outcomes and Complications. Cureus, 16(7), e64991. https://doi.org/10.7759/CUREUS.64991

Roh, Y. H., Hwangbo, K., Gong, H. S., & Baek, G. H. (2019). Comparison of Ultrasound-Guided Versus Landmark-Based Corticosteroid Injection for Carpal Tunnel Syndrome: A Prospective Randomized Trial. Journal of Hand Surgery, 44(4), 304–310. https://doi.org/10.1016/j.jhsa.2019.02.007

Rosario, N. B., & Jesus, O. De. (2023). Electrodiagnostic Evaluation of Carpal Tunnel Syndrome. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK562235/

Rotaru-Zavaleanu, A. D., Lungulescu, C. V., Bunescu, M. G., Vasile, R. C., Gheorman, V., Gresita, A., & Dinescu, V. C. (2024). Occupational Carpal Tunnel Syndrome: a scoping review of causes, mechanisms, diagnosis, and intervention strategies. Frontiers in Public Health, 12, 1407302. https://doi.org/10.3389/FPUBH.2024.1407302/BIBTEX

Schulze, D. G., Nilsen, K. B., Killingmo, R. M., Zwart, J. A., & Grotle, M. (2021). Clinical Utility of the 6-Item CTS, Boston-CTS, and Hand-Diagram for Carpal Tunnel Syndrome. Frontiers in Neurology, 12, 683807. https://doi.org/10.3389/FNEUR.2021.683807/FULL

Schwarz, A. M., Lipnik, G., Hohenberger, G. M., Krauss, A., & Plecko, M. (2022). Mini-open carpal tunnel release: technique, feasibility and clinical outcome compared to the conventional procedure in a long-term follow-up. Scientific Reports, 12(1), 9122. https://doi.org/10.1038/S41598-022-11649-Z

Shapiro, L. M., & Kamal, R. N. (2024). AAOS/ASSH Clinical Practice Guideline Summary Management of Carpal Tunnel Syndrome. The Journal of the American Academy of Orthopaedic Surgeons, 33(7), e356. https://doi.org/10.5435/JAAOS-D-24-01179

Sonoo, M., Menkes, D. L., Bland, J. D. P., & Burke, D. (2018). Nerve conduction studies and EMG in carpal tunnel syndrome: Do they add value? Clinical Neurophysiology Practice, 3, 78–88. https://doi.org/10.1016/J.CNP.2018.02.005

Turgut, M. C., Saglam, G., & Toy, S. (2021). Efficacy of extracorporeal shock wave therapy for pillar pain after open carpal tunnel release: a double-blind, randomized, sham-controlled study. The Korean Journal of Pain, 34(3), 315. https://doi.org/10.3344/KJP.2021.34.3.315

van den Broeke, L. R., Theuvenet, W. J., & van Wingerden, J. J. (2019). Effectiveness of mini-open carpal tunnel release: An outcome study. Archives of Plastic Surgery, 46(4), 350. https://doi.org/10.5999/APS.2018.00535

Wielemborek, P., Kapica-Topczewska, K., Pogorzelski, R., Bartoszuk, A., Kochanowicz, J., & Kułakowska, A. (2022). Carpal tunnel syndrome conservative treatment: a literature review. Postępy Psychiatrii i Neurologii, 31(2), 85–94. https://doi.org/10.5114/ppn.2022.116880

Woo, S. H., Choi, B. G., Woo, S. J., & Park, K. H. (2026). Current Surgical Trends in Carpal Tunnel Syndrome. Archives of Plastic Surgery, 53(1), 72. https://doi.org/10.1055/A-2769-7554

Wu, Y. T., Ho, T. Y., Chou, Y. C., Ke, M. J., Li, T. Y., Huang, G. S., & Chen, L. C. (2017). Six-month efficacy of platelet-rich plasma for carpal tunnel syndrome: A prospective randomized, single-blind controlled trial. Scientific Reports, 7(1), 94. https://doi.org/10.1038/S41598-017-00224-6

Xu, D., Ma, W., Jiang, W., Hu, X., Jiang, F., Mao, C., Wang, Y., Fang, L., Luo, N., Li, H., Lou, Z., & Gan, K. (2020). A randomized controlled trial: comparing extracorporeal shock wave therapy versus local corticosteroid injection for the treatment of carpal tunnel syndrome. International Orthopaedics, 44(1), 141–146. https://doi.org/10.1007/S00264-019-04432-9

Yang, F. A., Wang, H. Y., Kuo, T. Y., Peng, C. W., Liou, T. H., Escorpizo, R., & Chen, H. C. (2024). Injection therapy for carpal tunnel syndrome: A systematic review and network meta-analysis of randomized controlled trials. PLOS ONE, 19(5), e0303537. https://doi.org/10.1371/JOURNAL.PONE.0303537

Yoshii, Y., Zhao, C., & Amadio, P. C. (2020). Recent Advances in Ultrasound Diagnosis of Carpal Tunnel Syndrome. Diagnostics, 10(8), 596. https://doi.org/10.3390/DIAGNOSTICS10080596

Yunoki, M., Kanda, T., Suzuki, K., Uneda, A., Hirashita, K., & Yoshino, K. (2017). Importance of Recognizing Carpal Tunnel Syndrome for Neurosurgeons: A Review. Neurologia Medico-Chirurgica, 57(4), 172. https://doi.org/10.2176/NMC.RA.2016-0225

Zaki, H. A., Shaban, E., Salem, W., Bilal, F., Fayed, M., Hendy, M., Abdelrahim, M. G., Masood, M., khair, Y. M., & Shallik, N. A. (2022). A Comparative Analysis Between Ultrasound and Electromyographic and Nerve Conduction Studies in Diagnosing Carpal Tunnel Syndrome (CTS): A Systematic Review and Meta-Analysis. Cureus, 14(10), e30476. https://doi.org/10.7759/CUREUS.30476

Zhang, D., Chruscielski, C. M., Blazar, P., & Earp, B. E. (2020). Accuracy of Provocative Tests for Carpal Tunnel Syndrome. Journal of Hand Surgery Global Online, 2(3), 121–125. https://doi.org/10.1016/j.jhsg.2020.03.002

Zyluk, A. (2020). The role of genetic factors in carpal tunnel syndrome etiology: A review. Advances in Clinical and Experimental Medicine, 29(5), 623–628. https://doi.org/10.17219/ACEM/118846

Żyluk, A., & Żyluk, A. (2024). Effectiveness of non-operative methods of treatment of carpal tunnel syndrome: a narrative review. Wiadomości Lekarskie, 77(12), 2536–2545. https://doi.org/10.36740/WLEK/196561

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2026-09-24

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Cieślik, A., Cieślik-Porębska , M., Gąbka, M., Pelc, J., Cichocka , A., & Cieślik, A. A. . (2026). CURRENT TREATMENT STRATEGIES FOR CARPAL TUNNEL SYNDROME. A LITERATURE REVIEW. International Journal of Innovative Technologies in Social Science, 4(3(51). https://doi.org/10.31435/ijitss.3(51).2026.6159

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