Letters Section Editor: Stephen J. Lurie,
MD, PhD, Senior Editor.
To the Editor: Dr Gerritsen and colleagues1 found that carpal tunnel release surgery produced
better outcomes for patients with carpal tunnel syndrome (CTS) than did splinting.
The authors excluded individuals with a history of wrist trauma, surgery,
other medical conditions known to be associated with or to mimic CTS. However,
they did include individuals with occupations that place them at risk for
CTS. Because occupational exposure is the most common cause of CTS,2 patients randomized to splint treatment may have
had ongoing exposure to the cause of their CTS. By contrast, the group that
received surgery could have been away from work for as long as 12 weeks. Modification
of the ergonomic stressor is an integral part of the conservative management
Bleecker ML. Splinting vs Surgery for Carpal Tunnel Syndrome. JAMA. 2003;289(4):420-423. doi:10.1001/jama.289.4.420-a