الفهرس 
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Abstract
The aim of this study was to evaluate the effectiveness of conservative treatment of CTS clinically and electrophysiologically.
The study was carried out on 20 hands of patients (aged: 25-52 years) with mild to moderate CTS, the number of males constituted 5% and females were 95%. Patients were diagnosed as having CTS if they had: History of acroparasthesia and/or pain in the affected hand, Nocturnal exacerbation awaking the patient from sleep, Exacerbation of symptoms after manual work using the affected hand, Positive Phalen’s maneuver or reversed Phalen’s maneuver, and Sensory deficit limited to the distribution of the median nerve as it passes through the carpal tunnel, as well as patients positive electrophysiological testing for carpal tunnel syndrome.
All patients were selected from the outpatient’s clinic of Physical Medicine, Rheumatology and Rehabilitation Department, Faculty of Medicine Alexandria University. Patients were excluded from the study if they had one of the following: neuromuscular disorder, known endocrinal or rheumatological disorders, clinical manifestations suggesting radiculopathy, entrapment neuropathy in the upper limb other than carpal tunnel syndrome, a history of previous fracture of the upper limbs, negative electrophysiological testing for carpal tunnel syndrome, generalized edema, disabling disease (malignancy, cardiac, renal, hepatic, or pulmonary diseases), gastritis or peptic ulcer or evidence of severe CTS according to electrodiagnosis and/or clinical findings.
All patients were subjected to:
1) Personal data and history taking including parasthesia, nocturnal exacerbation, and exacerbation by manual work.
2) Clinical examination including general and neurological assessment.
3) Special tests (provocative tests).
4) Radiological examination to exclude cervical nerve root compression.
5) Electrophysiological examination (before and after treatment) including:
a) Motor conduction study of median and ulnar nerves.
b) Median and superficial radial (at wrist- to digit I segment) sensory conduction study. Also, median versus superficial radial sensory conduction study was done in those with normal median sensory conduction study.
6) Conservative treatment in the form of non-steroidal anti-inflammatory drugs (NSAIDs) and a night wrist splint (at neutral position) for 3 weeks and re-evaluation of patients clinically and electrophysiologically after treatment.
7) Surgical treatment for patients who did not respond satisfactorily to conservative treatment and their reevaluated clinically 4 weeks after surgery.
The study revealed that:
1. Carpal tunnel syndrome more common in females, right side or the dominant side, and manual workers and housewives.
2. The conservative treatment caused improvement of clinical symptoms in 85% of patients, although it did not affect the electrophysiological parameters in carpal tunnel syndrome.
3. Surgical treatment was successful in improving clinical symptoms in patients who did not respond satisfactorily to conservative treatment.