What is the prognosis of carpal tunnel syndrome (CTS)?

Updated: Mar 30, 2020
  • Author: Nigel L Ashworth, MBChB, MSc, FRCPC; Chief Editor: Milton J Klein, DO, MBA  more...
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Answer

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  • Carpal tunnel syndrome (CTS) appears to be progressive over time (although with considerable fluctuations from week to week) and can lead to permanent median nerve damage. Whether any conservative management can prevent progression is unclear. Even with surgical release, it appears that the syndrome recurs to some degree in a significant number of cases (possibly in up to one third after 5 years). [18]

  • Initially, approximately 90% of mild to moderate CTS cases respond to conservative management. Over time, however, a number of patients progress to requiring surgery.

  • Patients with CTS secondary to underlying pathology (eg, diabetes, wrist fracture) tend to have a less favorable prognosis than do those with no apparent underlying cause.

  • Patients with normal electrophysiologic studies consistently have much less favorable operative outcomes (and more complications) than do individuals with abnormalities on these tests. Axonal loss on electrophysiologic testing also indicates a less favorable prognosis.


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