Management of carpal tunnel syndrome

CTS: carpal tunnel syndrome; EDX: electrodiagnostic.

* CTS during pregnancy can be treated with nonsurgical options, such as wrist splinting, and usually resolves gradually after delivery. Refer to the UpToDate topic for additional details.

¶ Electrodiagnostic testing with nerve conduction studies and electromyography is performed to confirm the clinical diagnosis of CTS and to define the extent of median nerve injury. Refer to the UpToDate topic for additional details on other causes of CTS symptoms found on electrodiagnostic testing.

Δ Wrist splinting may be continued if effective for patients whose symptoms recur after stopping. Alternative therapies are indicated for patients whose symptoms recur after a second glucocorticoid injection or other measures. Refer to UpToDate topic for additional details.

◊ Wrist splinting and glucocorticoid therapy may be used as combination therapy for patients with partial improvement after an initial trial of either modality alone. Other options may be preferred by patients who are unable to adhere to splinting or who decline glucocorticoid therapy. Refer to the UpToDate topic for additional details.