The Carpal tunnel syndrome is the most common nerve entrapment syndrome: the median nerve is compressed in the carpal tunnel at the wrist due to swelling after overloading or anatomical factors (e.g. scarred tissue).
Tingling and numbness in the thumb, index and middle finger are typical, especially at night, later followed by weakness of the thumb muscles.
At the reference centre for Axomera therapy, you are treated by a medical team led by Prof. Molsberger.
From our patient consultations and the medical reports submitted.
Almost always in this order.
Night splint, NSAIDs and cortisone, surgery — the three pillars of conservative and surgical care. Here is what the current evidence base shows.
A night-time wrist splint keeps the wrist in a neutral position and relieves the median nerve at night. This often relieves night-time discomfort and pain in the short term. Controlled studies show a symptomatic effect over a few weeks; robust evidence for a lasting effect over several months is missing. The night splint is a safe, cost-effective first step — for many patients, it is not sufficient as a sole long-term therapy.
Page D et al. Splinting for CTS. Cochrane Database Syst Rev. — Chesterton LS et al. INSTINCTS trial. Lancet 2018;392:1423–1433. PMC6196880.
NSAIDs (ibuprofen, naproxen, diclofenac) are frequently prescribed, but the evidence for a specific effect on carpal tunnel syndrome is weak — they alleviate acute pain, but do not address the compression of the nerve. The local cortisone injection into the carpal tunnel is the best-studied conservative measure: after one month, patients show significant improvement more often than with a placebo (relative risk 2.58; 95% CI 1.72–3.87). There is no robust evidence for a clinically relevant effect beyond the first month; a second injection also provides no significant additional benefit. Oral cortisone administration is inferior to the local injection and is not advisable for long-term use due to systemic side effects.
Marshall S et al. Local corticosteroid injection for CTS. Cochrane Database Syst Rev CD001554. — Chesterton LS et al. Lancet 2018;392:1423–1433. PMC6196880. — Babaei-Ghazani A et al. Meta-analysis, n=448. PMC8128919.
Carpal tunnel surgery is among the most frequent elective procedures and provides significant improvement in night-time symptoms for most patients in the first few weeks. The complete return of strength and resilience takes several weeks to several months depending on the technique and initial severity. In long-term cohorts, reoperation rates are 1.4–4.4% (open) and 2.8–6.5% (endoscopic) respectively. Patients with electrophysiologically severe disease report significantly longer recovery times and less pain relief than patients with mild findings — precisely where the level of distress is greatest.
Wade RG et al. BJS Open 2024. PMC12284922. — Alqawasmi AS et al. 10-year follow-up, n=581. PMC12000157. — Guo D et al. J Clin Med 2024. PMC10779930. — Chapman CB et al. Hand (NY) 2012;7(3):242–246. PMC3418353.
I had been suffering from pain for five months, especially at night, and tingling in my fingers. The trigger was intensive gardening. Axomera had to be applied four times. The tingling reduced and the pain vanished. I am happy because my hand is healthy again and surgery could be avoided.
Documented individual case, with the patient's consent. Individual progress differs.
Wrist splints and cortisone injections often only alleviate symptoms temporarily, and surgical carpal tunnel release is a step that many patients would like to delay initially.
In the carpal tunnel, inflamed, swollen tissue presses on the median nerve; this swelling around the nerve — not the bony constriction itself — is the treatable component in many patients. The carpal tunnel lies directly under the skin on the palm side and is easily accessible from the outside.
Axomera targets this inflamed, swollen tissue: computer-controlled electrical signals in the dimension of cellular electrical fields are placed with millimetre precision around the median nerve. The goal is to reduce the swelling and raise the nerve's irritation threshold — an anatomically fixed constriction is not removed as a result.
How inflammation and pain are connected →We treat one level deeper — where the body regulates inflammation and healing itself.
Axomera is an internationally patented bioelectrical procedure.
How Axomera therapy works →In cases of pronounced nerve damage or increasing weakness and numbness, specialist, possibly surgical, clarification is necessary. In the event of relevant neurological deficits, you should seek specialist clarification immediately. Axomera is an individual treatment trial at the pain level; background: Med Devices 2018. This neurophysiological hypothesis is empirically based on many patient cases (real-world data), not on controlled studies; as with other indications, around 20–30% of those treated do not respond. In cases of anatomically fixed nerve constriction (narrowing, scar tissue), surgery is indicated — Axomera does not replace it in this instance.
Every therapy needs its own examination — for us, this includes the Axomera diagnostics and the Axomera therapy.
Axomera addresses the pain and irritation component at the wrist bioelectrically — at a different level than a splint, cortisone, and surgery; a mechanical constriction of the nerve is not removed as a result.
Axomera is an internationally patented bioelectrical procedure.
How Axomera therapy works →Developer of Axomera therapy · Medical Director
As the developer of Axomera therapy, he oversees the indication and is involved in your treatment personally upon request. His experience in conservative pain medicine informs the planning of your treatment series.
Doctor, orthopaedics & trauma surgery (in specialist training)
Performs your Axomera treatment and accompanies you throughout the entire treatment series. He reviews your findings and assesses whether the procedure is suitable for you. He also participates in the technical development.
Doctor, Specialist in Orthopaedics and Trauma Surgery
Organises your previous findings, performs Axomera diagnostics, and accompanies you throughout the entire treatment series. He reviews your findings and, based on his experience, assesses whether the procedure is suitable for you.
Three ways to reach us, around the clock, directly here on the site. For each, you can upload doctor's letters, findings, and MRI images at the same time — encrypted into your file, reviewed by a doctor before we speak.
Ten minutes with a doctor. Free of charge.
Medical assessment via video.
Examination, Axomera diagnostics, plan, costs.
Prefer personal contact? Call: +49 211 866880
Our practice treats exclusively by prior appointment.
The telephone initial assessment is not a treatment and does not replace an examination. Whether Axomera is suitable for you will be decided after a medical examination.
