A review of the literature demonstrates the effectiveness of various treatment options. Oztas, Turan, Bora and Karakaya (1998) studied the effectiveness of continuous ultrasound. It was discovered that there was no improvement in subjective symptoms, but there was a negative effect on motor nerve velocity, implying that ultrasound has a deleterious effect on carpal tunnel syndrome. On the other hand, Ebenbichler et al. (1998) found that pulsed ultrasound resulted in significant improvement with subjective symptoms and nerve conduction studies. These improvements continued after six months. Akalin et al. (2002) studied the effects of nerve and tendon gliding exercises on carpal tunnel syndrome symptoms. They found that performing these exercises combined with wearing wrist resting splint provided significant relief of symptoms. Their control group only wore the splints and they also reported decreased symptoms, but the extent of their relief was not as significant as the exercise group. Carter, Hall, Aspy and Mold (2002) studied the effects of magnetic therapy. They did not find any positive effects with their study. Yoga was studied as a possible treatment option by Garfinkel et al. (1998). They found that yoga allowed improvement of grip strength, pain reduction and the Phalen sign. They found no changes with sleep disturbance, Tinel sign, or nerve conduction studies. Therapeutic touch was tested by Blankfield et al. (2001). Their subjects received thirty minutes of therapeutic touch as compared to sham therapy. There was no relief of the carpal tunnel syndrome symptoms.

Medical interventions for carpal tunnel syndrome include prescription of NSAIDs, cortisone injections, and surgery. Further literature review was performed on medical interventions available for the treatment of carpal tunnel syndrome. Gerritsen, deVet, Scholten and Bertelsmann (2002) compared the effects of splinting with surgery. They found that after three months, patients who wore wrist splints reported 54% improvement, while the patients who had received surgery reported 80% improvement. After 18 months, the splinting group had 75% improvement and the surgical group had 90% improvement in symptoms. Tudiver, Johnson and Brown (2003) performed a literature review study and found that 33% of cases respond to splinting alone while surgery has a 90% success rate. They also compared the outcomes of open carpal tunnel release compared with endoscopy and found that they are equally effective, but the endoscopy patients have a faster return to function. Steroid injections were studied by Graham, Hudson, Solomons and Singer (2004). They gave their patients three betamethasone injections along with wrist splinting over the span of nine weeks. They found that these patients only had temporary relief of symptoms. Ten percent had long term relief and the remaining patients required open release surgery. Katz and Simmons (2002) noted 80% relief with wrist splinting. They stated that NSAIDs, diuretics and vitamin B6 were ineffective. Injections can be effective in 75% of cases, but recommend no more than three per year to avoid tendon rupture or nerve irritation. They recommend surgery if symptoms persist for greater than one year. They report 70-90% improvement with surgery, and also note some documented effectiveness with yoga and chiropractic treatment. Chung, Walters, Greenfield and Chernew (1998) studied the cost-effectiveness of endoscopy as compared to an open release. They found that endoscopy was more cost-effective, not because of the actual cost of surgery, but because of the decreased chance of complications, creating sociological costs. These complications were listed as median nerve transection and/or transient hand numbness. Trumble, Diao, Abrams and Gilbert-Anderson (2002) compared endoscopy with open release for effectiveness. They found that both surgeries were equally effective, but the endoscopy group demonstrated less scar tenderness and a quicker return to work. Lee and Jackson (1996) performed carposcopies, which is an open procedure, but the incision is smaller and is performed in a transverse manner. They reported that their patients had 86% relief in symptoms with no major complications. The fourteen percent that did not experience relief reported residual weakness and pain. They underwent open releases.