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Evaluation of Carpal Tunnel Diagnosis, Management, and Outcome in Primary Health Care Center

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Last updated: 03 Jan 2025

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Abstract

Background: Carpal tunnel syndrome (CTS) is one of the commonest conditions encountered in primary care centers as mentioned earlier. CTS of mild to moderate severity can often be effectively treated in a primary care environment. However, many patients being referred immediately to hospital for consideration of surgical decompression. Objective: In this study, we aim to evaluate the available primary care options and their efficacy in dealing with CTS. Methods: PubMed database was used for articles selection, and the following keys used in the mesh (("Carpal tunnel syndrome"[Mesh]) AND ("Carpal tunnel syndrome/Management"[Mesh] OR "Carpal tunnel syndrome/Diagnosis"[Mesh] OR "Carpal tunnel syndrome/ Primary Health Care Center)). 5 studies were enrolled according to our inclusion, and exclusion criteria. Results: Patients successfully treated with wrist splinting alone reported a higher level of satisfaction with their treatment compared to patients who failed wrist splint treatment or had surgical decompressionMechanical traction is associated with fewer surgical interventions compared to care as usual in CTS patients. Reductions in patient-reported symptoms at 6 months' follow-up was similar in both groups.Steroid injection combined with splinting resulted in modestly greater reduction of symptoms, functional recovery, and improvement of nerve function at 12-week follow-up compared to steroid injection alone. Conclusion: CTS is commonly encountered in primary care. So, a trial of conservative treatment can be done before referral for surgical decompression. Conservative treatment of CTS had shown a clear reduction in hand surgery waitlists, thus reduction in expenditures and costs. Wrist splinting is recommended as first line treatment for patients with symptoms of CTS. Other methods of non-surgical treatment include steroid injection, osteopathic manipulative therapy, mechanical wrist traction and combining wrist splinting with steroid injection or with NSAIDs use. Referral for surgical decompression may be a more appropriate option when the level of numbness and other symptoms are getting worse, or when conservative management has failed and is likely to lead to dissatisfaction.

DOI

10.21608/ejhm.2018.13711

Keywords

carpal tunnel, Diagnosis, Management, Outcome, Primary Health Care Center

Authors

First Name

Sahar Salem A

Last Name

Albalawi

MiddleName

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Affiliation

Tabuk university

Email

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City

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Orcid

-

First Name

Ruwaynah Waleed

Last Name

Aziz Alrahman

MiddleName

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Affiliation

Umm Al-Qura University

Email

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City

-

Orcid

-

First Name

Abdulrahman Mohsen

Last Name

Althagafi

MiddleName

-

Affiliation

Umm Al-Qura University

Email

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City

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Orcid

-

First Name

Abdulaziz Saud

Last Name

Alrahili

MiddleName

-

Affiliation

Umm Al-Qura University

Email

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City

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Orcid

-

First Name

Saad Saeed

Last Name

Alqahtani

MiddleName

-

Affiliation

Prince Sattam Bin Abdulaziz University

Email

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City

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Orcid

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First Name

Salman Mohammed

Last Name

Almutairi

MiddleName

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Affiliation

Prince Sattam Bin Abdulaziz University

Email

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City

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Orcid

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First Name

Dhafer Mubarak

Last Name

Alajmi

MiddleName

-

Affiliation

Prince Sattam Bin Abdulaziz University

Email

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City

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Orcid

-

First Name

Zeyad Saad

Last Name

Aljohani

MiddleName

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Affiliation

University of Jeddah

Email

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City

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Orcid

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First Name

Fahad Abdullah

Last Name

Abualnassr

MiddleName

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Affiliation

Taibah University

Email

-

City

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Orcid

-

First Name

Ammar Mohammed

Last Name

Sabah

MiddleName

-

Affiliation

Taibah University

Email

-

City

-

Orcid

-

Volume

73

Article Issue

3

Related Issue

2442

Issue Date

2018-10-01

Receive Date

2018-09-15

Publish Date

2018-10-01

Page Start

6,230

Page End

6,237

Print ISSN

1687-2002

Online ISSN

2090-7125

Link

https://ejhm.journals.ekb.eg/article_13711.html

Detail API

https://ejhm.journals.ekb.eg/service?article_code=13711

Order

7

Type

Original Article

Type Code

606

Publication Type

Journal

Publication Title

The Egyptian Journal of Hospital Medicine

Publication Link

https://ejhm.journals.ekb.eg/

MainTitle

Evaluation of Carpal Tunnel Diagnosis, Management, and Outcome in Primary Health Care Center

Details

Type

Article

Created At

22 Jan 2023