Surgery or No Surgery for Two Common Compressive Neuropathies?

In 2025, researchers reported results of the largest randomized trials ever published comparing surgical and nonsurgical management of two common compressive neuropathies — carpal tunnel syndrome and cervical radiculopathy.

Carpal tunnel syndrome management has depended largely on symptom severity: Patients with mild symptoms usually receive nonoperative therapies. and those with severe symptoms undergo surgical decompression. In a multicenter randomized trial, 900 participants with carpal tunnel syndrome (of varying severity) received either surgical decompression or corticosteroid injections. At 18-month follow-up, 61% of the surgery group and 45% of the injection group met symptom recovery thresholds (no or mild residual symptoms). About …