Research-Based Treatment of Carpal Tunnel Syndrome

The aim of treatment for CTS is to reduce symptoms (pain, tingling, numbness), to improve hand function and minimize loss of time from work. (1)  Several conservative treatment options have been documented in the literature.

 In addition to rest (taking breaks and decreasing frequency of repetitive movements) and making changes in mechanical stresses at work (including ergonomics), some studies have supported the use of wrist splints.  One randomized clinical trial reported that nocturnal wrist splints (night splints) compared to no treatment significantly improved symptoms at 4 weeks. (3)

Research-Based Massage for Carpal Tunnel Syndrome

Massage is another conservative treatment therapy for CTS that has shown some promise. One recent research study evaluated the efficacy of massage therapy as a treatment for CTS. First, the locations of trigger-points that referred pain and tingling into the hand were identified.  Twenty-one participants then received 30 min of massage, twice a week, for six weeks. Carpal tunnel questionnaires, the Phalen, Tinel, and two-point discrimination tests were used for outcome assessment. The results demonstrated significant (p < 0.001) changes in symptom severity and functional status from the two week point on. Based on this study, the combination of massage and trigger-point therapy is a viable treatment option for carpal tunnel syndrome and offers a new treatment approach.(4 )

Another study aimed to evaluate the effectiveness of two distinct massage therapy protocols on strength, function, and symptoms associated with CTS.  This was a randomized pilot study design with double pre-tests and subjects blinded to treatment group assignment. Twenty-seven  subjects with a clinical diagnosis of CTS were included in the study.  Subjects were randomly assigned to receive 6 weeks of twice-weekly massage consisting of either a general massage or CTS-targeted massage treatment program. Outcome measures included hand grip strength and key pinch strength using dynamometers, Levine Symptom and Function evaluations, and the Grooved Pegboard test. Evaluations were conducted twice at the beginning (baseline), 2 days after the 7th and 11th massages, and at a follow-up visit 4 weeks after the 12th massage treatment. Results showed improvements in strength and function which lasted at least 4 weeks post-treatment. Comparatively, the CTS-targeted massage resulted in greater gains in grip strength than the general massage (p = 0.04), with a 17.3% increase over baseline (p < 0.001). The general massage group only showed a 4.8% gain(p = 0.21). Significant improvement in grip strength was observed following the 7th massage. No other comparisons between treatment groups attained statistical significance. Both the general massage group and CTS-targeted group resulted in improvement of subjective measures, but improvement in grip strength was only detected with the CTS-targeted massage. The study concluded that massage therapy may be a practical conservative intervention for CTS, although additional research is needed.(5)

One study compared a new massage technique with the night splint, of which the efficacy in CTS has been proven with many studies. Eighty-four patients between 31 and 65 years of age were included in the study. The patients were divided into two equal groups. In the first group, splint and "Madenci" hand self-massage technique were applied, and in the second group only splint was applied. A splint was provided for all patients with tendon and nerve gliding exercises, and also when needed analgesic drugs were given. When the pretreatment and posttreatment outcome measures were compared, it was found that pain and nerve symptoms were significantly decreased in both groups (P = 0.001) and grip strength was significantly increased (P = 0.001). The posttreatment pain, nerve symptoms and grip strength scores were significantly improved in the massage group compared to the night splint group (P < 0.05). The authors of this study concluded that the Medenci hand self-massage technique is an inexpensive, practical treatment that every patient with CTS can apply to him/herself easily.(6)

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