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Journal of Hand Surgery (European Volume)
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Articles

Severity Scoring in Carpal Tunnel Syndrome Helps Predict the Value of Conservative Therapy

B. J. OLLIVERE
K. LOGAN
N. ELLAHEE
J. C. A. MILLER-JONES
M. WOOD
D. S. NAIRN

From the Department of Trauma and Orthopaedics, Princess Alexandra Hospital, Harlow, Essex, UK

Correspondence: Ben Ollivere, 5 Orchard Close, Eye, Suffolk, IP23 7DW, UK. E-mail:ben{at}ollivere.co.uk.

A prospective study was performed to assess the outcome of conservative treatment of carpal tunnel syndrome and to establish the predictive value of preoperative Boston carpal tunnel questionnaire scores. Sixty-seven patients with 101 symptomatic hands underwent an evidence-based education and conservative therapy regime prior to surgery. All patients were scored using the Boston carpal tunnel questionnaire at presentation and at 3 months. Fifty-eight of 67 patients completed both assessments providing a complete assessment of 89 symptomatic hands. The mean Boston carpal tunnel questionnaire scores improved significantly from 2.45 to 2.12 and throughout the duration of the study 73% of patients improved with conservative treatment and 14% did not require surgery. Severity scoring at presentation was predictive of outcome with conservative therapy. This work suggests that the Boston carpal tunnel questionnaire can be used to identify patients who are likely to respond to conservative treatment.

Key Words: carpal tunnel syndrome • conservative therapy • scoring • neuropathy

This version was published on August 1, 2009

Journal of Hand Surgery (European Volume), Vol. 34, No. 4, 511-515 (2009)
DOI: 10.1177/1753193409102380
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