Functional Outcome following Conservative Management of Mild to Moderate Carpal Tunnel Syndrome

Open Access

Abstract

Background: Carpal tunnel syndrome (CTS) is a common neuropathy caused by median nerve compression at the wrist, resulting in pain, numbness, and tingling. Conservative treatment is generally recommended for mild to moderate CTS and includes wrist splinting, corticosteroid injection, and physical therapy. Although these approaches can improve symptoms and hand function, evidence on their functional outcomes in Bangladeshi patients remains limited. Therefore, this study aimed to evaluate symptom improvement and functional outcomes following conservative treatment in patients with mild to moderate CTS. Methods & Materials: A prospective study was conducted among 60 patients with mild to moderate CTS. Clinical symptoms, Boston Carpal Tunnel Questionnaire (BCTQ) scores, grip and pinch strength, and pain intensity were assessed at baseline and after 6 weeks of conservative treatment. Clinically meaningful functional improvement was defined as a ≥0.5-point reduction in the BCTQ Functional Status Score. Results: Among 60 patients, the mean age was 44.3 ± 8.7 years and 63.3% were female. Nocturnal paresthesia (88.3%) was the most common symptom, followed by numbness (83.3%). After 6 weeks of conservative treatment, BCTQ symptom severity and functional status scores significantly improved (2.86 to 1.92 and 2.63 to 1.78, respectively; both p<0.001). Grip strength, pinch strength, and VAS pain scores also improved significantly (all p≤0.002). Clinically meaningful functional improvement was achieved by 38 (63.3%) patients. Improvement was significantly higher in mild CTS than moderate CTS (74.3% vs. 48.0%; p=0.039). Conclusion: Conservative treatment improved symptoms and function in mild to moderate CTS, particularly in mild cases, supporting its use as first-line management.