Determinants of Remission in Medically Treated Carpal Tunnel Syndrome: Study from Central India.

BACKGROUND

The factors associated with the spontaneous remission (SR) of symptoms in carpal tunnel syndrome (CTS) are not well known.

OBJECTIVES

To look for determinants of SR in medically treated, electrophysiologically proven patients of CTS.

METHODS

We revisited the medical records and nerve conduction study data of 130 hands with CTS and divided them into two groups as per the absence or persistence of the symptoms when contacted after a median time lapse of 3 years following the diagnosis.

RESULTS

SR occurred in 46.1% of the hands. Higher odds of SR were linked with female gender, symptoms restriction to lateral fingers, symptom duration <10 months, mildly delayed median motor and sensory distal latencies, and median sensory amplitude >20 μV. We developed a seven-point scale, on which a score of ≥4 had a strong association (odds ratio 4.31) with SR.

DISCUSSION AND CONCLUSION

No single risk factor, standalone, can predict SR in patients with CTS, which could lead to an invasive treatment (Surgery or local injection) to them. We propose that patients scoring ≥4 on our 7 point scale should be treated medically for the initial 10 months after the symptom onset.