American Board of Internal Medicine (ABIM) Certification Practice Exam

For carpal tunnel syndrome management, what conservative treatment may help patients with obesity?

1. Exercise therapy

2. Weight reduction

3. Oral steroids

4. Hydrotherapy

The correct answer is: Weight reduction

Weight reduction is a highly relevant conservative treatment for managing carpal tunnel syndrome, especially in patients who are obese. Obesity has been identified as a contributing factor to the increased incidence and severity of carpal tunnel syndrome because excess weight can lead to increased pressure on the median nerve within the carpal tunnel. By losing weight, patients can decrease the overall burden that may be contributing to nerve compression, thus potentially alleviating symptoms. Weight reduction not only reduces the physical pressure on the carpal tunnel but can also lead to a decrease in systemic inflammation, which may further improve nerve function. When patients achieve a healthier weight, they may experience reduced pain and improved hand function, making weight management an effective strategy in the overall treatment plan for those with carpal tunnel syndrome. Other treatment options, while beneficial in various contexts, do not address the underlying issue of obesity directly related to the condition. For example, exercise therapy can improve strength and function, but without addressing the weight itself, the benefits may be limited in obese individuals. Similarly, oral steroids can reduce inflammation temporarily but do not provide a long-term solution or address the causes linked to obesity. Hydrotherapy may offer some relief but lacks the direct impact that weight reduction has on the underlying factors associated with carpal