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Research-Based Massage for Carpal Tunnel Syndrome (2 CE Hours)

This course is approved by the Texas Department of State Health Services DSHS for Continuing Education for Massage Therapists CE0009 and by the NCBTMB for Nationally Certified Massage Therapists for 2 CE Hours.

This article reviews the latest clinical research that has reported the effectiveness of massage therapy for the treatment of Carpal Tunnel Syndrome. 

Learning Objectives: After reading this course, you will...

  1. be able to describe the research-based anatomy associated with carpal tunnel syndrome.
  2. be able to list and describe the types of symptoms associated with carpal tunnel syndrome that can be influenced positively by massage therapy, according to the research.
  3. be able to list specific massage therapies that have evidence to support their use on carpal tunnel syndrome, according to the research.
  4. be able to explain the research efficacy of massage therapy in the treatment of symptoms of carpal tunnel syndrome.
  5. be able to describe what type of massage is best in the treatment of carpal tunnel syndrome, according to the research.
  6. be able to list the research studies promoting the efficacy of massage for carpal tunnel syndrome.

 

Introduction to Research-Based Massage for Carpal Tunnel Syndrome

Carpal tunnel syndrome (CTS) is a common peripheral nerve entrapment that causes neuralgia in the median nerve distribution of the hand.  The carpal tunnel is an oval shaped passageway between the carpal bones of the wrist and the flexor retinaculum. Eight tendons pass through the carpal tunnel: the tendons of the flexor digitorum superficialis and flexor digitorum profundus.  The median nerve also passes through the carpal tunnel and is vulnerable to compression if any of the tendons or tendon sheaths become swollen from overuse.

Carpal Tunnel

CTS is one of the most common repetitive motion disorders that is often associated with repetitive use of the fingers and/or wrist, especially in occupations requiring strong gripping, bending of the wrist, or use of vibrating tools. Classic symptoms include numbness, tingling, burning, or pain in at least two of the three digits supplied by the median nerve (i.e., the thumb and the index and middle fingers). (1) Symptoms can resolve within 6 months in about one third of people — particularly younger people — whereas poor prognosis is often indicated by bilateral symptoms and a positive Phalen's test.  (1)  Prevalence of CTS is 1-4% of the population in men and 5-7% in women.(1)  Most cases of CTS have idiopathic onsets with no identifiable cause. (1)
CTS is a major, costly public health issue that could be dramatically affected by the identification of additional conservative care treatment options.

Research-Based Assessment in Carpal Tunnel Syndrome

In addition to the classic symptoms of finger numbness, tingling, burning and/or pain, patients with CTS often have palpable wrist pain and positive special tests.  Special tests include Tinel’s Sign (tapping over the palmer side of the wrist causes tingling or shooting pain into the fingers is a positive test), Phalen’s Sign (placing the wrist in end-range flexion causes reproduction of symptoms is a positive test), Electromyelogram (EMG) study of the nerve conduction velocity across the carpal tunnel (a compromised carpal tunnel will show a reduction in nerve conduction velocity).  Research reports that 34% of all cases of CTS with idiopathic onset resolve within 6 months regardless of treatment. (2)

Phalen's Test for CTS

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