Carpal tunnel syndrome: surgical and nonsurgical treatment.

A retrospective study was performed to evaluate treatment for carpal tunnel syndrome. Two hundred sixty-five patients were treated over a 4 1/2-year period. Only patients in whom studies showed abnormal nerve conduction (a median nerve sensory latency greater than 3.6 msec or a median distal motor latency greater than 4.3 msec) were included in the evaluation. Nonsurgical treatment consisted of patient education, wrist splinting, B vitamins, nonsteroidal anti-inflammatory medication, steroid injections, and job change or modification when possible. A follow-up history, physical examination, and repeat nerve conduction studies were performed at 3- to 9-month intervals, depending on the severity of symptoms and the degree of abnormal latencies. Surgery was performed on 77 patients and 95 hands. The remaining 188 patients were treated nonsurgically. Both surgically and nonsurgically treated patients considered the results to be satisfactory.