Non-surgical treatment approaches for carpal tunnel syndrome (CTS) aim to remove pressure on the median nerve where it pinches. A recent review of the literature published on “passive modalities” (non-surgical treatment approaches) for CTS. Researchers reviewed studies published between 1990 and 2015 for information on which non-surgical treatment approaches work best. Topping the list is the use of various types of night splints. Wrist braces are worn at night to prevent bending of the wrist during sleep. Evidence shows that night splints are less effective than surgery in the short term (up to six months). They are more effective over the long term (at 12 and 18 months)!
They did not find studies with a “low risk of bias” (no randomized controlled trial types of studies) regarding other passive modalities such as ultrasound and electrical stim. Hence, they conclude that better-quality studies must happen before conclusions can be made regarding passive modalities in CTS management.
CTS Mobilization Treatments
A 2010 study found mobilization treatments and exercises (tendon gliding & nerve gliding) were helpful WHEN patients complied with the treatments and the recommended exercises. Manual therapies, or “hands-on” treatments, are a feature of chiropractic care. Chiropractic treatment for patients with CTS also includes night bracing in addition to manipulation, mobilization, exercise training, nutrition, ergonomic/workstation modifications, and whole-body health awareness.
Doctors of chiropractic understand these non-surgical approaches have limitations. This is why they work with allied healthcare providers when pharmaceutical and/or surgical intervention is appropriate. They may also frequently consult with neurologists for tests such as EMG/NCV. These are electrical tests that measure the degree of nerve damage to better understand the patient’s condition. In short, chiropractic offers a multi-modal approach to care, and chiropractors will work with others in the patient’s best interest.
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