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AAOS releases new guidelines for diagnosis, treatment of carpal tunnel syndrome
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The board of directors for the American Academy of Orthopaedic Surgeons recently approved new guidelines on carpal tunnel syndrome that recommend the use of a complete patient history and specific physical examination maneuvers, as well as observation and specific diagnostic tests, to better diagnose the condition.
According to a press release from the group, the “Management of Carpal Tunnel Syndrome Evidence-Based Clinical Guidelines” do not recommend the use of routine MRI scans to diagnose carpal tunnel syndrome (CTS).
“One physical examination maneuver is not enough to definitely diagnose carpal tunnel syndrome,” Brent Graham, MD, MSc, FRCSC, an orthopedic surgeon and chair of the American Academy of Orthopaedic Surgeons Diagnosis and Treatment of Carpal Tunnel Syndrome Work Group, said in the release. “These guidelines should help doctors make an accurate diagnosis of CTS more easily and with fewer tests. This means treatment, that is based on evidence, can be started earlier and with a greater likelihood of success.”
The work group found strong evidence for the association between thenar atrophy and CTS, but according to the release, noted a lack of atrophy is insufficient to rule out CTS. The new guidelines recommend single results from common tests and maneuvers, medical history and demographics data should not be independently used to confirm a diagnosis of CTS.
The guidelines recommend splinting and the use of steroids, ketoprofen phonophoresis gel and/or magnetic therapy for the treatment of CTS. Surgery is recommended, when necessary, to release the transverse carpal ligament to relieve symptoms and improve hand function.
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