Carpal Tunnel Syndrome

Operative Release Versus Ketogenic Diet: A Pilot Study in Metabolic Reality

Abstract

Background
Carpal tunnel syndrome (CTS) is one of the most common entrapment neuropathies and a frequent indication for surgery. Meanwhile, CTS is strongly associated with obesity, insulin resistance, type 2 diabetes, and fluid retention. The relationship between metabolic health and median nerve compression is well described, but rarely acted upon.

Objective
To compare outcomes of surgical carpal tunnel release (CTR) with a ketogenic diet intervention in patients with CTS.

Methods
Twenty fictional patients with clinically and electrophysiologically confirmed CTS were allocated to either surgical release (n = 10) or a ketogenic diet (n = 10). Outcomes included symptom relief, recurrence, patient satisfaction, and the ability to button shirts without swearing.

Results
Both groups improved. The diet group improved more broadly.

Conclusion
In metabolically unhealthy patients, addressing the cause of nerve compression may be at least as effective as surgically releasing the consequence.