Randomized clinical trial of surgery versus conservative therapy for carpal tunnel syndrome [ISRCTN84286481]

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Randomized clinical trial of surgery versus conservative therapy for carpal tunnel syndrome [ISRCTN84286481]

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dc.contributor.author Martin, Brook I. en_US
dc.contributor.author Levenson, Linda M. en_US
dc.contributor.author Hollingworth, William en_US
dc.contributor.author Kliot, Michel en_US
dc.contributor.author Heagerty, Patrick J. en_US
dc.contributor.author Turner, Judith A. en_US
dc.contributor.author Jarvik, Jeffrey G. en_US
dc.date.accessioned 2010-04-21T15:57:39Z
dc.date.available 2010-04-21T15:57:39Z
dc.date.issued 2005 en_US
dc.identifier.citation Martin B, Levenson L, Hollingworth W, et al. Randomized clinical trial of surgery versus conservative therapy for carpal tunnel syndrome [ISRCTN84286481]. BMC Musculoskeletal Disorders. 2005;6(1):2. en_US
dc.identifier.other 10.1186/1471-2474-6-2 en_US
dc.identifier.uri http://www.biomedcentral.com/1471-2474/6/2 en_US
dc.identifier.uri http://hdl.handle.net/1773/15787
dc.description.abstract Background: Conservative treatment remains the standard of care for treating mild to moderate carpal tunnel syndrome despite a small number of well-controlled studies and limited objective evidence to support current treatment options. There is an increasing interest in the usefulness of wrist magnetic resonance imaging could play in predicting who will benefit for various treatments. Method and design: Two hundred patients with mild to moderate symptoms will be recruited over 3 1/2 years from neurological surgery, primary care, electrodiagnostic clinics. We will exclude patients with clinical or electrodiagnostic evidence of denervation or thenar muscle atrophy. We will randomly assign patients to either a well-defined conservative care protocol or surgery. The conservative care treatment will include visits with a hand therapist, exercises, a self-care booklet, work modification/ activity restriction, B6 therapy, ultrasound and possible steroid injections. The surgical care would be left up to the surgeon (endoscopic vs. open) with usual and customary follow-up. All patients will receive a wrist MRI at baseline. Patients will be contacted at 3, 6, 9 and 12 months after randomization to complete the Carpal Tunnel Syndrome Assessment Questionnaire (CTSAQ). In addition, we will compare disability (activity and work days lost) and general well being as measured by the SF-36 version II. We will control for demographics and use psychological measures (SCL-90 somatization and depression scales) as well as EDS and MRI predictors of outcomes. Discussion: We have designed a randomized controlled trial which will assess the effectiveness of surgery for patients with mild to moderate carpal tunnel syndrome. An important secondary goal is to study the ability of MRI to predict patient outcomes. en_US
dc.description.sponsorship The study is funded by the National Institute of Arthritis and Musculoskeletal Skin Disease (NIAMS) (P60 AR48093). en_US
dc.language.iso en_US en_US
dc.title Randomized clinical trial of surgery versus conservative therapy for carpal tunnel syndrome [ISRCTN84286481] en_US
dc.type Article en_US


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