Table 4.

2016 American Academy of Orthopaedic Surgeons Clinical Practice Guidelines Regarding Treatment of Carpal Tunnel Syndrome.

Recommendation
Strong	The use of immobilization other than in the postoperative period (brace/splint/orthosis) and steroid injection may improve symptoms Not using magnet therapy Surgical release should improve symptoms and function and it should have a greater treatment benefit at 6 and 12 months compared with splinting, nonsteroidal anti-inflammatory drugs/therapy, and a single steroid injection
Moderate	No benefit of oral treatments not including steroids (which has moderate evidence of improving patient-related outcomes compared with placebo) Ketoprofen phonophoresis could provide reduction in pain The fact that there is no benefit to routine inclusion of the following adjunctive techniques: epineurotomy, neurolysis, flexor tenosynovectomy, and lengthening/reconstruction of the flexor retinaculum (transverse carpal ligament)
Limited	Therapeutic ultrasound might be effective Laser therapy might be effective If surgery is chosen, an endoscopic carpal tunnel release based on possible short-term benefits may be considered The use of local anesthesia rather than intravenous regional anesthesia because it might offer longer pain relief after surgery There is no benefit for routine use of prophylactic antibiotics