American Board of Internal Medicine (ABIM) Certification Practice Exam

What type of treatment may be appropriate for mild to moderate carpal tunnel syndrome if there is no evidence of weakness?

1. Surgical intervention

2. Conservative treatment

3. Electrical stimulation therapy

4. Intravenous medication

The correct answer is: Conservative treatment

Mild to moderate carpal tunnel syndrome, especially in the absence of weakness, is often managed effectively with conservative treatment measures. These may include activities such as wrist splinting, particularly at night, which can help keep the wrist in a neutral position and reduce nocturnal symptoms. Ergonomic adjustments at work, activity modification, and stretching exercises are also commonly recommended. The rationale for choosing conservative treatment over more invasive methods, such as surgical intervention, lies in the nature of the condition at mild to moderate levels, where there is typically no permanent nerve damage or significant functional impairment. These conservative approaches aim to alleviate symptoms and improve the patient's quality of life without subjecting them to the risks and recovery time associated with surgical procedures. While electrical stimulation therapy might provide some symptomatic relief, it is not usually the first line of treatment for carpal tunnel syndrome. Intravenous medication is generally not indicated for this condition, as it is more tailored to acute, systemic issues rather than localized nerve compression. Thus, conservative treatment stands out as the most fitting and effective option for managing mild to moderate cases of carpal tunnel syndrome.