Chicago,
Sept 10 (AP)- Surgery for carpal tunnel syndrome produces better
long-term results in most patients than the more common treatment of
putting a splint on the wrist, new research suggests.
The
syndrome, which is often associated with use of computer keyboards, can
cause numbness, tingling and pain in the fingers, hands and wrists. It
occurs when tendons leading form the hand become swollen and press on a
nerve in a region of the wrist called the carpal tunnel. It affects an
estimated five million Americans and is a significant cause of missed
work days.
More than
200,000 carpal tunnel operations are done in the United States each
year, but splinting is thought to be the most common treatment and is
generally tried before surgery is considered.
Splints keep
the wrist from bending, easing pressure on a nerve. Surgery involves
making a small incision in the wrist and cutting the carpal ligament
away from the median nerve to relieve pressure. It is under local
anesthesia and generally takes less than an hour.
In the study
by researchers in the Netherlands, 176 patients had surgery or wore
wrist splints for at least six weeks; they were then evaluated
periodically. After three months, significant improvement was seen in 80
percent of surgery patients, compared with 54 percent of splint
patients. At 18 months, the success rate remained significantly higher
for the surgery group.
The findings
are to appear Wednesday in The Journal of the American Medical
Association.
Because the
researchers did not study patients who had very mild or severe cases,
the study does not prove that surgery is best for everyone, said Dr.
Shaw Wilgis, research director at Curtis National Hand Center in
Baltimore. Nor did the study examine anti-inflammatory drugs, which are
sometimes prescribed.
