INTRODUCTION: Carpal tunnel syndrome is a neuropathy caused by compression of 
the median nerve within the carpal tunnel. However, the severity of symptoms and 
signs does not often correlate well with the extent of nerve damage.
METHODS AND OUTCOMES: We conducted a systematic review and aimed to answer the 
following clinical questions: What are the effects of drug treatments, non-drug 
treatments, surgical treatments, and postoperative treatments for carpal tunnel 
syndrome? We searched: Medline, Embase, The Cochrane Library and other important 
databases up to December 2006 (Clinical Evidence reviews are updated 
periodically, please check our website for the most up-to-date version of this 
review). We included harms alerts from relevant organisations such as the US 
Food and Drug Administration (FDA) and the UK Medicines and Healthcare products 
Regulatory Agency (MHRA).
RESULTS: We found 54 systematic reviews, RCTs, or observational studies that met 
our inclusion criteria. We performed a GRADE evaluation of the quality of 
evidence for interventions.
CONCLUSIONS: In this systematic review we present information relating to the 
effectiveness and safety of the following interventions: acupuncture; diuretics; 
carpal tunnel release surgery (open, and endoscopic); internal neurolysis; local 
and systemic corticosteroids; massage therapy; nerve and tendon gliding 
exercises; non-steroidal anti-inflammatory drugs; pyridoxine; therapeutic 
ultrasound; and wrist splints.