By Jerry Moczerniuk
PT, DPT
Carpal tunnel syndrome is characterized by multiple symptoms and signs that occur following compression of the median nerve within the wrist. Usual symptoms include numbness, tingling, burning and pain in a specific distribution within a specific pattern in the hand. These symptoms may also include strength deficits and loss of sensation in the affected hand.
Carpal tunnel syndrome is the most common nerve entrapment/compression disorder of the upper extremity. This disorder affects 1 percent of the general population and up to 5 percent of the working population, particularly individuals who use their hands for work. In the United States, there are over 460,000 carpal tunnel releases annually.
A recent study published in the Journal of Sports and Physical Therapy evaluated the effectiveness of manual therapy versus surgery on function, neck mobility and strength in women diagnosed with carpal tunnel syndrome.
In this study 100 women with carpal tunnel syndrome were randomly allocated to either a manual therapy group or a surgery group. Authors compared the scores on self-rated hand function scales, active neck range of motion, pinch-tip grip forc, and the symptom severity questionnaire. Patients were assessed at baseline and 1, 3, 6 and 12 months after the last treatment was administered.
At 12 months, analysis showed statistically significant differences favoring the manual therapy group at 1 month for self-reported function, and grip force on the symptomatic side. Improvements in self-reported function and pinch grip force were similar between the groups at 3, 6, and 12 months. Both groups reported improvements in symptom severity that were not significantly different at all follow-up periods.
The authors concluded that manual therapy and surgery had similar effectiveness for improving self-reported function, symptom severity, and pinch grip force on the symptomatic hand.
Physical therapists are trained in joint mobilization and manual treatment techniques as those described in the above mentioned research. Considering the findings of the study, physical therapy should be utilized as the primary treatment approach for individuals suffering from carpal tunnel syndrome.
Dr. Moczerniuk is a Doctor of Physical Therapy, member of American Physical Therapy Association, and a clinical director at db Orthopedic Physical Therapy of Manalapan LLC, located at 120 Craig Rd. Suite 2. Dr. Moczerniuk can be reached at 732-462- 2162 or via e-mail at jerry@dborthopt.com. You can also find out more about our practice at dborthopt.com.
