So often we hear, “…well if it’s so good, show me
the proof!” Chiropractic case management
of CTS has been well established for many years. And yet, we still hear skepticism from
patients, MD’s, insurers, employers, and others about the benefits of
chiropractic management of CTS. If we
can, “show them the data” regarding the effectiveness of chiropractic for CTS
patients, we will finally be able to help more people with this potentially
disabling condition.
So, let’s take a look at the evidence that supports
the benefits of chiropractic for CTS:
1) Davis PT, Hulbert JR, Kassak KM, et al.
“Comparative efficacy of conservative medical and chiropractic treatments for
carpal tunnel syndrome: a randomized clinical trial”
J Manipulative Physiol Ther.
21.5 (June 1997): 317-326.
The most important finding reported in this 91
patient study was that chiropractic treatment was equally effective in reducing
CTS symptoms as medical treatment. The
chiropractic care included ultrasound, nighttime wrist supports and
manipulation of the wrist, arm and spine.
Medical care included ibuprofen (800 mg, 3x/day for 1 wk, 800 mg, 2x’day
for 1 wk, & 800 mg as needed for 7
wks) plus a night wrist splint. Both
groups did equally well but given the side-effect potential of ibuprofen on the
stomach, liver, and kidneys, a strong argument for the non-drug, chiropractic
approach can be made.
2) Bonebrake
AR, Fernandez JE, Marley RJ et al. “A treatment for carpal tunnel syndrome: evaluation
of objective and subjective measures” J Manipulative Physiol Ther. 13.9
(Nov-Dec 1990): 507-520
CTS sufferers (n=38) received chiropractic spinal
manipulation and extremity adjusting.
Also, soft tissue therapy,
dietary modifications or supplements (B6) and daily exercises were prescribed.
After treatment, results showed improvement in all strength and range of motion
measures. Also, a significant reduction
in pain and distress ratings was reported.
3) Mariano KA, McDougle MA, Tanksley GW “Double
crush syndrome: chiropractic care of an entrapment neuropathy” J
Manipulative Physiol Ther. 14.4 (May 1991):262-5
In 1973, Upton and McComas first proposed the
presence of the "double crush syndrome." Their hypothesis was that
when a nerve is pinched anywhere along its route, it makes the rest of the
nerve more sensitive to otherwise “normal” stimulation. A case report of a man
with both cervical radiculopathy and carpal tunnel syndrome, i.e., "double
crush syndrome" was presented. Chiropractic management consisted of
chiropractic manipulative therapy as well as ultrasound, electrical nerve
stimulation, traction and a wrist splint. The experimental basis, clinical
evidence, etiology, symptomatology and findings of this condition are
discussed. The Double Crush Syndrome
helps explain why cervical/neck manipulation helps many CTS patients.
