Surgical Versus Conservative Management for Carpal Tunnel Syndrome: An Updated Systematic Review of Randomised Trials.

Study Summary

4 randomized controlled trials including 1158 adults with carpal tunnel syndrome (CTS) were included in this systematic review comparing carpal tunnel release with corticosteroid injection or percutaneous electrical nerve stimulation. Outcomes included pain, paraesthesia, symptom severity, function, clinical recovery, satisfaction, additional treatment, and adverse events over 6 weeks to 18 months. Because interventions, outcome measures, and follow-up periods varied substantially, the findings were synthesized narratively rather than pooled in a meta-analysis. Conservative treatments generally provided faster short-term symptom relief, whereas surgery produced a higher probability of sustained clinical recovery at 12 to 18 months. Overall, treatment choice should reflect whether the patient prioritizes rapid symptom control or long-term functional recovery.