Carpal Tunnel Syndrome - Treatment

However, a recent analysis compared the effects of local steroid injection versus surgery in patients with new CTS of at least 3 months' duration. Over the short term, local steroid injection was better than surgery for relieving symptoms of CTS. And after 1 year, local steroid injection was as effective as surgery.Another study compared steroid injection with open-release surgery and found that the surgery resulted in better outcomes but not improved grip strength in patients with CTS over a 20-week period.

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Most doctors limit steroid injections to about three per year, since they can cause complications such as rupture of tendons, nerve irritation, or more widespread side effects such as hypertension or elevated blood sugar levels.

Low-Dose Oral Corticosteroids. Short-term use (two to four weeks) of low-dose oral corticosteroids may provide long term relief. In one study, between a third and half of patients who took the corticosteroid prednisolone for two to four weeks were still pain-free after a year.

It should be noted that oral steroids can have serious side effects, although they are likely to be minimal when taken in low doses for a brief period.

Yoga and Other Exercise Programs

Yoga. Some evidence suggests that yoga practice may be specifically very helpful for carpal tunnel, since yoga postures are designed to stretch, strengthen, and balance upper body joints. In one study, people who practiced yoga for eight weeks experienced significantly reduced symptoms compared to wrist splints or no treatment at all. Two other small studies also reported improvement in pain relief. Some people anecdotally report that positive effects take a few weeks of regular practice of at least two sessions a week.

General Exercise Program. Some experts have reported that people who are physically fit, including athletes, joggers, and swimmers, have a lower risk for cumulative trauma disorders. Although there is no evidence that exercise can directly improve CTS, a regular exercise regimen using a combination of aerobic and resistance training techniques strengthens the muscles in the shoulders, arms, and back, helps reduce weight, and improves overall health and well-being. In one 2001 study, CTS patients experienced symptom relief and signs of improved nerve conduction after 10 months of participation in an aerobic exercise program. (Such improvements appeared to be due to both weight loss and higher oxygen levels.) One study found that most people with CTS felt improvement after two months of physical therapy that included exercises to improve balance and posture. People with any chronic medical condition or with risk factors for heart disease should check with their doctors about an appropriate regimen.