Surgery for carpal tunnel syndrome has modest benefits over non-surgical treatment in patients without an indication of denervation, finds a new study published in the journal Lancet.

Researchers led by professor Jeffrey Jarvik of the Harborview Medical Center in Seattle, Wash., compared outcomes among carpal tunnel patients who underwent surgery and those who had non-surgical treatment, such as hand therapy and ultrasound. Using the Carpal Tunnel Syndrome Assessment Questionnaire, they found that 46% of surgery patients after 12 months showed at least a 30% improvement in CTSAQ scores for hand function and symptoms, as well as minimal interference in their daily activities. Twenty-seven percent of the non-surgery patients showed the same positive outcomes.

Although they note that some surgery patients reported persistent symptoms, the authors conclude that, overall, the study shows surgery to yield better improvements in hand function and symptoms than non-surgical interventions for carpal tunnel syndrome without denervation.

"Future studies should compare the overall costs of surgical and non-surgical treatments, to take into consideration all relevant aspects," write Swedish researchers Isam Atroshi, MD, and Christina Gummesson, MD, in a commentary on the study. "Nevertheless, patients with carpal tunnel syndrome who do not have satisfactory improvement with non-surgical treatment should be offered surgery."

Irene Tsikitas