Differences in outcomes according to the primary treatment options chosen by patients with carpal tunnel syndrome and negative neurophysiological studies: Conservative versus operative treatment. Do we need neurophysiological studies?


carpal tunnel syndrome ; DASH questionnaire ; Boston questionnaire ; mini open carpal tunnel release

Published online: May 29 2020

Olga D. Savvidou, Nikolaos A. Stavropoulos, George Chloros, Vasileios I. Sakellariou, Leonidas Dimopoulos, Panayiotis J. Papagelopoulos

From the 1st Department of Orthopedics, National and Kapodistrian Univeristy of Athens, Medical School, Attikon University General Hospital, Athens, Greece


The purpose of this study is to compare the outcomes of conservative versus operative treatment in patients with a positive history and clinical findings for Carpal Tunnel Syndrome (CTS) and negative nerve conduction studies (NCS).

A cohort of 126 consecutive patients (34 males, 92 females) with mean age of 48 years old, positive history and clinical findings for CTS but negative NCS was studied. The mean duration of symptoms was 9.1 months. Group I (94 patients) underwent conservative treatment, whereas group II (32 patients) underwent mini open carpal tunnel release.

The clinical diagnosis was based on the Harrington criteria. Patients were evaluated at baseline and at 12-months follow-up using the Boston Carpal Tunnel Questionnaire (BCTQ) and the Disabilities of the Arm, Shoulder and Hand (DASH) instrument.

At baseline, group I had lower BCTQ and DASH scores, compared to the respective scores of group II. At the final 12-month follow-up, patients in group I had higher BTCQ scores. Post-treatment, group II showed significant improvement of BTCQ score (p< 0.001) and DASH score (p<0.05).

The additional value of NCS is limited when there is strong clinical suspicion.