Related Experiment Video
Updated: Jan 23, 2026

Metacarpal Small Incision for Carpal Tunnel Syndrome
Published on: April 5, 2024
[Should carpal tunnel syndrome treatment start with surgery or an injection?]
W A C Palmbergen1, A M Heeren2, R M A de Bie2
1BovenIJ ziekenhuis, afd. Neurologie, Amsterdam; Contact: w.palmbergen@bovenij.nl
Objective:
Surgery and corticosteroid injections are established treatments for carpal tunnel syndrome (CTS), but the optimal treatment strategy remains unclear. The DISTRICTS aimed to compare the efficacy of surgery with injection.
Design:
Open-label, randomised controlled trial in the Netherlands.
Method:
CTS patients were randomly assigned to start treatment with either surgery or an injection. Additional treatments were allowed. The primary outcome was the proportion of patients who recovered-defined as a score of fewer than eight points on the 6-item CTS scale at 18 months.
Results & Conclusion:
934 participants were enrolled. The recovery rate in the surgery group was 61% and significantly higher than the 45% recovery rate in the injection group. In patients with CTS, initiating treatment with surgery offers a higher chance of recovery after 18 months compared to starting with a corticosteroid injection.
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