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Carpal Tunnel Syndrome and how to manage it


What is Carpal Tunnel Syndrome?

Carpal Tunnel Syndrome is a collection of symptoms that affect the hand, wrist and fingers of one or both hands (typically 1 hand), often due to the compression of the median nerve at the bones of the wrist (aka the carpal tunnel). Sometimes, an exact cause can not be found, with or without advanced imaging, such as a nerve conduction study. As this systematic review describes, "Patients with CTS often report pain, paraesthesia, sensory disturbances, weakness in the hand and wrist, causing a physical function decrease that affects daily living activities."


Furthermore, management usually begins with conservative treatment. Night splints are a good idea because this condition often makes it difficult to sleep. A night splint helps to keep the wrist in neutral, which may prevent the wrist becoming numb or painful, and may improve the quality of sleep. A common clinical indicator is sometimes mentioned by a patient in their history. A "flick sign" is often reported, where by the patient will flick their hand to attempt to rid themselves of the pain, tingling or numbness.


This systematic review suggests various types of soft tissue techniques and neurodynamic mobilisations are effective for treating this condition. These manual therapy techniques described are some of the instrument techniques which Dr. Bulman also incorporates into soft tissue treatments. Also, neural glides and sliders are part of an exercise program that can be incorporated into both treatment and home exercise programs.


In conclusion, "This study highlights the effectiveness of manual therapy techniques based on soft tissue and neurodynamic mobilizations, in isolation, on pain, physical function, and nerve conduction studies in patients with Carpal Tunnel Syndrome."



Sources: Jiménez-Del-Barrio S, Cadellans-Arróniz A, Ceballos-Laita L, Estébanez-de-Miguel E, López-de-Celis C, Bueno-Gracia E, Pérez-Bellmunt A. The effectiveness of manual therapy on pain, physical function, and nerve conduction studies in carpal tunnel syndrome patients: a systematic review and meta-analysis. Int Orthop. 2022 Feb;46(2):301-312. doi: 10.1007/s00264-021-05272-2. Epub 2021 Dec 3. PMID: 34862562; PMCID: PMC8782801.


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