Manual Therapy vs. Surgery for Carpal Tunnel Syndrome

When people suspect they have carpal tunnel syndrome (CTS), it’s typical that their first thought is that their condition will require surgery and a lengthy recovery. While surgery may be warranted in emergency situations, treatment guidelines encourage patients to seek non-surgical options first. So how do non-surgical approaches like manual therapy interventions —provided in a chiropractic setting—compare with surgery to treat CTS?

In 2018, a team of European researchers reviewed data from ten studies that compared the effectiveness of surgery vs. non-surgical care for the treatment of CTS. While the results favored non-surgical approaches at three months and surgery at six months, the available data show no difference in outcome one year later. Thus, the research team concluded that conservative treatment should be preferred unless otherwise indicated.

If both surgery and non-surgical options produce similar outcomes at the one-year mark, can CTS improve on its own?

In one study that involved 22 patients (19 of whom had CTS in both hand), researchers incorporated a twelve-week waiting period into the experiment to see if symptoms worsened, stayed the same, or improved. Questionnaires completed by the participants who abstained from manual therapy interventions showed that their symptoms worsened during the twelve-week non-treatment period.

The treatment phase of the study involved six sessions twice a week for three weeks and incorporated manual therapies to address the soft tissues of the hand and wrist and the carpal bones. The patients reported that treatment resulted in improvements with respect to both pain and function. This led the researchers to recommend manual therapy interventions as a valid non-surgical treatment approach for CTS.

Doctors of chiropractic specialize in manual therapy techniques and employ these regularly for many neuromusculoskeletal conditions, including CTS and related conditions that may contribute to a patient’s hand and wrist symptoms—something that a carpal tunnel release procedure cannot address. To achieve optimal results, it’s important to seek PROMPT assessment and non-surgical treatment for CTS.

Author
Dr. James Sheehan Dr. James Sheehan is an expert in the treatment of neck and back pain.

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