Practice patterns in the conservative treatment of carpal tunnel syndrome: Survey results from members of the American Society of Hand Therapy

• Published in: Journal of hand therapy 2020-07, Vol.33 (3), p.346-353
• Main Authors: Parish, Robin, Morgan, Christy, Burnett, Caitlin A., Baker, Beverly C., Manning, Calland, Sisson, Sydney K., Shipp, Elizabeth Rush
• Format: Article
• Language: English
• Subjects: Carpal tunnel syndrome; Certified hand therapist; Clinical decision making; Compression; Conservative management; Decision making; Hand; Health services; Intervention; Median nerve; Oral administration; Orthoses; Overuse injuries; Patients; Physical therapists; Polls & surveys; Researchers; Studies; Systematic review; Therapy; Ultrasonic imaging
• ISSN: 0894-1130; 1545-004X
• DOI: 10.1016/j.jht.2019.03.003

A cross-sectional descriptive design was used. Carpal tunnel syndrome (CTS) is a complex combination of symptoms resulting from compression of the median nerve within the carpal tunnel. A study that compares the conservative interventions identified in the literature with the actual conservative interventions being implemented by therapists for the treatment of CTS is not presently available. The purpose of this study was to examine conservative interventions for CTS as reported by certified hand therapists (CHTs) within various clinical settings. The study also aimed to identify the decision-making process for the selection of CTS interventions. CHT members of the American Society of Hand Therapists were surveyed electronically to obtain quantitative data. Patient education, nocturnal orthosis, and ergonomic modifications ranked among the top conservative interventions utilized for CTS, whereas treatments such as magnet therapy, C-TRAC, and heating lamps ranked among the least utilized interventions. When selecting interventions, clinical expertise, research evidence, and patient preferences were all highly valued considerations for CHT. Our study offers a unique summary of CHT practice patterns for CTS interventions and the associated decision-making processes. It compares findings with existing literature on this topic, offering researchers and clinicians a glimpse of the CTS practice trends. This study may serve to prioritize future research studies based on the prevalence of intervention usage among the experts. It also serves as a guide to those seeking to understand the most common interventions utilized for conservative CTS treatment. •Cross-sectional survey of hand therapists describing intervention preferences and decision-making process for carpal tunnel syndrome.•The most common carpal tunnel syndrome intervention utilized was education, followed closely by nocturnal orthosis and ergonomic modifications.•All aspects of evidence-based practice (ie, expertise, evidence, and patient preferences) were highly valued by 90% of respondents.