Surgical Procedures Versus Nonoperative Treatments
Strong evidence supports that surgical treatment of carpal tunnel syndrome should have a greater treatment benefit at 6 and 12 months as compared to splinting, NSAIDs/therapy, and a single steroid injection.

Rationale
Four high quality (Gerritsen 2002, Hui 2005, Ismatullah 2013, and Jarvik 2009) and 3 moderate quality (Andreu 2013, Ly 2005, and Ly-Pen 2012) studies compared the effectiveness of surgical treatment to non-operative treatment for the relief of CTS symptoms. All three studies showed that surgery was superior for the relief of daytime and nocturnal paresthesias and return of grip strength.  Of these, one high quality (Gerritson 2002) and one moderate quality study (Andreu 2013) examined the long term outcomes for surgery versus conservative treatment and found better results with surgery