Carpal tunnel syndrome (CTS) occurs when the mobility of the median nerve is impeded as it passes through the wrist. Outside of emergency circumstances, clinical guidelines recommend that patients exhaust conservative options before consulting with a surgeon. The most common conservative treatments are splinting of the wrist, steroid injection, electrotherapy, and manual therapy.
CTS Published Reviews
Previously published reviews on the use of manual therapies for CTS also included other conservative therapies. It makes it challenging to determine if manual therapies alone are effective or only with other forms of treatment. A study reviews to uncover the effectiveness of manual treatment for mild-to-moderate CTS. The authors of a 2022 systematic review looked at data on 410 patients from six studies. They concluded that the use of manual therapies not only improves CTS-related symptoms but also the function of the median nerve itself with nerve conduction velocity testing.
Chiropractors train in manual therapies of many varieties. These include joint manipulation, mobilization, instrumentation use, soft-tissue mobilization, massage, neuro mobilization methods (nerve gliding at the cervical spine, thoracic outlet, brachium/arm, antebrachium/forearm, wrist, hand and fingers, etc.
It’s important to note that restriction or compression of the median nerve anywhere can increase the risk for CTS. It even leads to symptoms that mimic the condition. In fact, there’s research that supports that the use of manual therapies to reduce the perineural tethering in the forearm can improve the movement of the median nerve during finger, hand, wrist, and elbow movements. Hence the importance of evaluating the full course of the median nerve when a patient seeks care for CTS.
Conclusion
The data suggests that manual therapies alone may be sufficient to manage CTS. Doctors of chiropractic will often utilize a multimodal approach that also includes specific exercises, physiotherapy modalities, nocturnal splinting, nutrition recommendations, and more. All with the aim of helping the patient experience maximum improvement in the shortest amount of time so they can return to their normal life and work activities.
