Patient Information (NHS England) - Carpal tunnel syndrome release patient leaflet
If severity is mild to moderate, conservative management is first line.
- Treat any underlying cause (e.g., rheumatoid arthritis, hypothyroidism, obesity)
- If the symptoms are mild and not progressing then:
- Explain that the symptoms may resolve within 6 months
- Advise wearing a wrist splint at night that maintains the wrist at a neutral angle without applying direct compression
- Any improvement should be apparent within 8 weeks of use
- Advise minimization of activities that exacerbate symptoms
- Do not recommend the use of non-steroidal anti-inflammatory drugs or diuretic medication.
- If symptoms of CTS do not improve after six months, or if they get worse, consider additional treatment with corticosteroids. There is no evidence to support giving more than one injection.
NB: Nerve Conduction and electromyography studies are not usually necessary and should not be undertaken routinely in primary care. It should also not be used routinely in secondary care, but may be helpful where there is diagnostic doubt - a clear explanation must be given why the testing is required and must be recorded within the patient’s health records for audit purposes.
Referral criteria for surgical intervention
Surgical intervention for carpal tunnel syndrome will be funded for patients registered with NHS West Norfolk, NHS North Norfolk, NHS Norwich, NHS South Norfolk and Great Yarmouth and Waveney CCGs meeting one or more of the following criteria:
- There is no improvement after adequate conservative treatment.
- If symptoms become severe or constant even after conservative treatment.
- There is severe constant sensory disturbance and/or thenar motor weakness.
- There is progressive motor or sensory deficit.
- There are severe symptoms that significantly interfere with patients daily activities.
|Latest change to document
||8 February 2018
||22 May 2018
|Next Review date