Prognosis

Untreated CTS can spontaneously improve in up to one third of individuals, particularly in younger women (this finding may reflect the natural course of pregnancy-induced CTS).[41]​​[42]

Wrist splints

Most studies show about a 70% chance of improvement with splints after a period of weeks to months.​​[43][44]​[45][47][60]​​​​ Treatment seems to be less successful over the long term and in those with severe CTS.

Corticosteroid injection

Corticosteroid injections are associated with an improvement in hand function at 6 months, and a reduction in the need for surgery at 12 months compared with placebo.[48]​ Evidence is too uncertain for reliable conclusions to be drawn about the benefits of corticosteroid injections compared with surgery for patients with carpal tunnel syndrome based on the comparison of ​single corticosteroid injections with surgery.[49]​ A more appropriate comparison to evaluate the benefits of these treatments would be multiple corticosteroid injections versus surgery.

Surgery

There are no studies that compare surgery with placebo or no treatment, but patients treated with surgery in other comparisons usually show success rates of about 80% to 90%.[61][62]​​ After surgery, there is little evidence for any particular rehabilitation program being superior to another; therefore, choice is based on the patient’s and clinician’s preference.[57]​​​​

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