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January 22/29, 2003

Splinting vs Surgery for Carpal Tunnel SyndromeSplinting vs Surgery for Carpal Tunnel Syndrome

Author Affiliations

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2003;289(4):420-423. doi:10.1001/jama.289.4.420-a

To the Editor: In his Editorial1 that accompanied the study by Gerritsen et al,2 Dr Wilgis suggested that surgery should be preferred to wrist splinting. He did not mention other treatment modalities. In February 2002, the Food and Drug Administration approved the use of an 830-nm gallium aluminum arsenide laser for treatment of CTS based on experimental data,3 which confirm prior results.4 Naeser et al,5 in a placebo-controlled trial, applied laser light to acupuncture points in conjunction with transcutaneous electric nerve stimulation, resulting in an 88% decrease in neuropathic pain and improved sensory nerve conduction. The concomitant benefit of transcutaneous electric nerve stimulation suggests that other energy modalities on the electromagnetic spectrum may also be effective. Finally, a colleague and I reported that the constant wearing of static, permanent, multipolar magnetic wrist devices for 1 month produced significant reduction of neuropathic pain in refractory cases (57%) and distal motor latencies compared with placebo.6

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