Severity scoring in carpal tunnel syndrome helps predict the value of conservative therapy

• Published in: The Journal of hand surgery, European volume Vol. 34; no. 4; p. 511
• Main Authors: Ollivere, B J, Logan, K, Ellahee, N, Miller-Jones, J C A, Wood, M, Nairn, D S
• Format: Journal Article
• Language: English
• Published: England 01.08.2009
• Subjects: Adrenal Cortex Hormones - administration & dosage; Adult; Aged; Aged, 80 and over; Analgesics - therapeutic use; Carpal Tunnel Syndrome - classification; Carpal Tunnel Syndrome - diagnosis; Carpal Tunnel Syndrome - therapy; Female; Humans; Injections, Intra-Articular; Male; Middle Aged; Patient Education as Topic; Physical Therapy Modalities; Prognosis; Psychometrics - statistics & numerical data; ROC Curve; Splints; Surveys and Questionnaires; Treatment Outcome
• ISSN: 2043-6289
• DOI: 10.1177/1753193409102380

A prospective study was performed to assess the outcome of conservative treatment of carpal tunnel syndrome and to establish the predictive value of preoperative Boston carpal tunnel questionnaire scores. Sixty-seven patients with 101 symptomatic hands underwent an evidence-based education and conservative therapy regime prior to surgery. All patients were scored using the Boston carpal tunnel questionnaire at presentation and at 3 months. Fifty-eight of 67 patients completed both assessments providing a complete assessment of 89 symptomatic hands. The mean Boston carpal tunnel questionnaire scores improved significantly from 2.45 to 2.12 and throughout the duration of the study 73% of patients improved with conservative treatment and 14% did not require surgery. Severity scoring at presentation was predictive of outcome with conservative therapy. This work suggests that the Boston carpal tunnel questionnaire can be used to identify patients who are likely to respond to conservative treatment.