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From the Istituto di Neurologia (Drs. L. Padua, Aprile, and Tonali), Università Cattolica S.C., Rome; AFaR–CRCCS Centro di Statistica Medica (Drs. L. Padua and Pasqualetti), Osp. Fatebenefratelli Isola Tiberina, Rome; Istituto Pro Iuventute (Dr. L. Padua), Don C. Gnocchi, Rome; Dipartimento Ortopedia (Dr. R. Padua), Ospedale S. Giacomo, Rome; IRCCS (Dr. Pasqualetti), Centro S. Giovanni di Dio, FBF, Brescia; and CSS Hospital (Dr. Tonali), IRCCS, S. Giovanni Rotondo, Italy.
Address correspondence and reprint requests to Dr. Luca Padua, Institute of Neurology, Università Cattolica, L.go F. Vito 1 00168, Rome, Italy; e-mail: lpadua{at}mclink.it
Objective: To assess the course of untreated carpal tunnel syndrome (CTS).
Methods: The Italian CTS Study Group prospectively followed up (10 to 15 months) 196 untreated patients (274 hands) with idiopathic CTS with multiple measurements of CTS. Baseline factors were used to predict the evolution of untreated CTS in multiple regression analysis. Results: Comparison of baseline and follow-up data showed a significant spontaneous improvement of patient-oriented and neurophysiologic measurements. A significant correlation between evolution and initial severity of CTS was observed. CTS measurements improved in patients with more severe initial impairment whereas they worsened in patients with milder initial impairment. The main positive prognostic factor was short duration of symptoms. Similarly, spontaneous improvement was more frequently associated with young age. Conversely, baseline bilateral symptoms and positive Phalen predicted a poor prognosis. Conclusions: Some patients with CTS improve spontaneously without surgical treatment.
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