# Evolution of Carpal Tunnel Syndrome Treatment: A Narrative Review

## TL;DR

This paper reviews the history and current approaches to treating carpal tunnel syndrome, highlighting surgical and non-surgical methods and future directions.

## Contribution

The paper provides a comprehensive narrative review of the evolution and emerging trends in carpal tunnel syndrome treatment.

## Key findings

- Surgical techniques like endoscopic release offer faster short-term recovery compared to open surgery.
- High-resolution ultrasound improves early detection and assessment of median nerve compression.
- Regenerative biologics and minimally invasive innovations show promise as future treatment options.

## Abstract

Carpal tunnel syndrome (CTS) is the most common peripheral nerve entrapment disorder, with a lifetime prevalence estimated at approximately 10%. This narrative review explores the historical evolution, current management strategies, and emerging trends in CTS diagnosis and treatment. Early recognition of CTS led to the development of conservative interventions, including splinting, corticosteroid injections, and physical therapy, aimed at alleviating median nerve compression and associated symptoms. The advent of open carpal tunnel release established surgery as the definitive treatment for moderate-to-severe CTS, with subsequent refinements—such as mini-open and endoscopic techniques—focused on minimizing tissue trauma and expediting recovery. Comparative studies demonstrate similar long-term efficacy between surgical modalities, though endoscopic approaches often provide faster short-term recovery. Advances in diagnostic imaging, including high-resolution ultrasound, have improved early detection and dynamic assessment of median nerve compression. Emerging therapies, such as regenerative biologics, neuromobilization, and minimally invasive surgical innovations, offer promising adjuncts to current care. Despite substantial progress, further research is needed to clarify optimal patient selection, refine minimally invasive techniques, and explore regenerative interventions. This review underscores the importance of individualized, evidence-based, and patient-centered approaches to CTS management, integrating both established and emerging strategies to optimize functional outcomes and quality of life.