Carpal Tunnel Syndrome Guidelines Published

By Kelly Young

Edited by André Sofair, MD, MPH, and William E. Chavey, MD, MS

The American Academy of Orthopaedic Surgeons has issued new guidelines on managing carpal tunnel syndrome.

To diagnose carpal tunnel syndrome, the group does not recommend routinely using magnetic resonance imaging or ultrasound. The following are recommended: a thorough patient history, certain physical examination maneuvers, observation, and specific diagnostic tests, such as the hand-held nerve conduction study device. The authors emphasize that no single element should be used alone to make a diagnosis.

Thenar atrophy is associated with carpal tunnel syndrome, but the syndrome cannot be ruled out in the absence of thenar atrophy.

For treatment, the group recommends immobilization, oral or injectable steroids, and ketoprofen phonophoresis gel, and recommends against magnet therapy. It also recommends surgery to release the transverse carpal ligament to help restore hand function and ease symptoms.