Table 3.

Possibly Effective Nonsurgical Treatments for Carpal Tunnel Syndrome

Treatment	Initial Success	Long-Term Success	Evidence	Advantages	Disadvantages
Laser-acupuncture	Reduction in night pain but not paraesthesia	Unknown	1 poor-quality RCT14	Possible preoperative analgesic agent	Poor availability
Nerve and tendon gliding exercises	No significant difference for Phalen’s or Tinel’s sign, or nerve conduction studies	Significantly reduced rates of surgery	Before-and-after study using historical controls26	Noninvasive	Reduced surgical rates may result from confounders
		NNT = 4
Ultrasound	One study suggested improvement in both symptoms and nerve conduction studies19; other study found no significant difference25	Unknown	2 RCTs19,25	Noninvasive	Expensive
			Conflicting evidence		High dropout rate
Wrist splinting	Neutral superior to 20o extension splinting	Unknown	1 systematic review35 plus 1 RCT19	No harmful effects noted	Poor compliance
	Full-time use significantly greater improvement in nerve conduction studies but no difference in symptoms		All studies had methodological flaws
Yoga	Significant improvement in Phalen’s sign, grip strength, and pain reduction but not Tinel’s sign, sleep disturbance, or nerve conduction studies	Unknown	RCT (single-blind)21	Noninvasive	No changes in nerve conduction studies
				Can be home-based treatment
					Involves high level of patient commitment
	Control group had wrist splinting.

RCT = randomized controlled trial; NNT = number needed to treat.