Carpal tunnel syndrome occurs when
the median nerve, which starts at the neck and runs from the forearm into the
hand, becomes compressed or squeezed at the wrist. In some cases there may also
be compression at the spine.
The median nerve controls sensations
to the palm side of the thumb and fingers (but not the little finger), as well
as impulses to some small muscles in the hand that allow the thumb and fingers
to move.
A recent study in the Journal of
Manipulative and Physiological Therapeutics compared two different conservative
treatments for patients with mild to moderate carpal tunnel symptoms. One
treatment was the Graston technique, which uses an instrument to rub the
forearm, wrist and hand areas to breakdown scar tissue and adhesions. In the
other treatment a chiropractor applied deep pressure by hand to the same areas.
These treatments are thought to release tight muscles and myofascial
restrictions.
The patients got the treatments
twice each week for four weeks followed by one treatment a week for two
additional weeks. The patients also did at-home stretching exercises. They did
not use common conservative treatments such as wrist splints and
anti-inflammatory medications.
After both interventions, there were
objective improvements to nerve conduction latencies (nerve function), wrist
strength, and wrist motion. The patient symptoms of pain also improved, and
both groups reported high satisfaction with the care they received.
Despite surgery being in widespread
use in the US for carpal tunnel syndrome, it is important for conservative
treatments to be tried prior to an invasive operation.
The surgical complication rates are
low but when they do occur, can be devastating. In addition to direct surgery
costs, one has to also consider disability payments (not working), and
rehabilitation that may take several weeks. These costs can be substantial. For
this reason, many medical doctors recommend conservative treatments first.
Of all the conservative options,
manual therapy by a chiropractor is an excellent choice. It comes without the
side effects associated with long-term use of medications.
A comprehensive examination by a
Doctor of Chiropractic can determine if your carpal tunnel symptoms are likely
to respond to care. He or she can also advise on at-home stretching exercises
that can be done to help recovery. In some cases, hidden spinal and neck
problems can influence carpal tunnel symptoms, and be the key to treating the
cause vs. the symptom.
