Carpel tunnel syndrome may wane with time

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Carpel tunnel syndrome may wane with time

By Amy Norton

SAN FRANCISCO, Mar 02 (Reuters Health) - People with the repetitive stress

injury carpal tunnel syndrome can be treated with everything from painkillers to

surgery, but for many patients the problem may simply go away, Italian

researchers said on Thursday.

In a study of 354 patients referred to surgeons at eight centers in Italy,

investigators found that for about one third of the patients, time healed at

least some wounds. Over the course of about one year, more than 200 of the study

patients were left untreated, only " sporadically " using anti-inflammatory

medication when they needed pain relief. By the end of the study, patients'

reports and tests of nerve function in the wrist showed that 34% had seen their

symptoms improve, while 21% had worsened.

The findings show that carpal tunnel syndrome can often resolve on its own, and

that surgery may be an overused treatment strategy, Dr. o Padua of San

Giacomo Hospital in Rome told Reuters Health.

He presented his team's findings here at the annual meeting of the American

Academy of Orthopedic Surgeons.

Marked by numbness and tingling in the hand and wrist, and pain that can extend

up to the shoulder, carpal tunnel syndrome may be caused by work or hobbies that

involve repetitive motions of the upper limbs. Swelling in the wrist compresses

nerves that travel from the forearm to the hand through a " tunnel " in the wrist.

Treatment includes painkillers, braces, steroid injections into the joint, and

surgery to " release " the ligament that runs through the tunnel and puts pressure

on nerves.

While surgery may be necessary for some patients, Padua said, he and his

colleagues wanted to discern which patients do well with minimal treatment. They

found that the younger a patient was, the better the chances of improving

without therapy. For each year in a patient's age, Padua reported, the odds of

improving without treatment declined 4%.

In addition, having carpal tunnel syndrome in only one hand boosted the odds of

improvement: patients with two injured limbs were 70% less likely to see their

symptoms ease.

Padua said doctors should take patients' age into consideration when deciding

treatment, holding off on surgery for younger ones. He said he favors several

months of conservative treatment unless the patient's symptoms are severe and

long-standing.