● Interference with sleep : The paresthesia and similar sensations experienced often wake up patients several times per night. The lack of sleep creates a secondary list of health challenges and occupational concerns (Patel et al., 2014).
nuanced as treatments and self-care become less effective or if the condition worsens over time. ● Loss of gripping and/or pinching strength : Lifting, carrying, and moving objects becomes more challenging as hand strength weakens over time. Supportive wrist guards become a useful tool for the patient to supplement their lost strength. ● Compression of the anterior wrist, recreating the symptoms. Compression does not need to be deep; as little as one pound of pressure is enough to illicit a neurological or a pain response. ● A wrist square test measuring the ratio of wrist thickness to wrist width can be utilized. A value exceeding 0.7% indicates a higher risk of developing CTS. ● Examination of the wrist circumference itself. If wrist circumference is less than 6 inches for females or less than 7 inches for males, one is more at risk of acquiring CTS.
DIAGNOSTIC FEATURES
● X-rays that determine inflammation or structural damage to carpal bones can be a powerful diagnostic tool. ● Electromyogram tests will determine muscular activity within a region. Improper nerve supply causes the muscles to atrophy and activity to diminish. ● A nerve conduction study to determine electrical impulse flow through the wrist: This exam, combined with prior mentioned diagnostic tools, can become a powerful measure for CTS potential, as well as current diagnosis. (National Institute of Neurological Disorders and Stroke [NINDS], 2020)
ECONOMIC IMPACT
tracked in three adult age ranges for at least 11 months. Results indicated that CTS patients slept 2.5 hours less than recommended for their respective age ranges and were more at risk for comorbid conditions. CTS patients consistently reported awakening on multiple occasions due to paresthesia and similar phenomena. Malalignment of the wrist joint (caused by various sleeping positions) is said to create these sensations. Patients with other sleep-related disorders, including sleep apnea, were excluded from the study to aid in data clarity (Patel et al., 2014). The American Academy of Orthopaedic Surgeons (AAOS) updated their clinical practice guideline for CTS management, which concluded that the financial burden of CTS symptom management increased from $2.7 billion to $4.8 billion dollars annually in the U.S. (AAOS, 2024).
The economic impact of carpal tunnel syndrome has been measured and researched by numerous organizations in recent decades. Impacts differ based on demographic and psychogenic factors, yet carpal tunnel syndrome has conclusively been found to negatively affect economies. According to Gabrielli and colleagues (2020), the number of carpal tunnel releases (CTRs) that were performed have increased by 38%. Work missed due to carpal tunnel syndrome has resulted in monetary loss to both individuals and the economy. Patients with CTS missed on average 28 days of work per year. Patel and colleagues (2014) published a journal article on the correlation of sleep disorders and CTS. Measuring results via Levine-Katz Carpal Tunnel and Pittsburgh Sleep Quality Index (PSQI) questionnaires, 66 CTS patients were
CURRENT RESEARCH FINDINGS
tunnel questionnaires and various physical tests. The results showed a significant improvement in symptoms and functional status from two weeks onward (p < 0.001). The study concludes that combining massage with trigger point therapy is a viable treatment option for carpal tunnel syndrome. “Reliability and Efficacy of the new Massage Technique on the Treatment in the Patients with Carpal Tunnel Syndrome”; Madenci, E., Altindaq O., Yilmaz M., & Gur A.; Rheumatology International , October 2012 Summary : This study introduced a new Madenci hand massage technique for treating carpal tunnel syndrome (CTS) and compared its effectiveness with the proven method of wearing a splint. Eighty-four patients ages 31 to 65 years were divided into two groups: One group received both the splint and the Madenci massage, while the other group received only the splint. Both groups also performed tendon and nerve gliding exercises and used analgesics as needed. Results showed significant improvements in pain (PGA and MDPGA) and grip strength in both groups ( p = 0.001). However, the group that received the massage showed significantly better posttreatment results compared to the splint-only group ( p < 0.05). This study is the first and largest to evaluate this massage technique, highlighting its ease of self- application, affordability, and practicality for all CTS patients.
Numerous research studies indicate the efficiency of manual therapy techniques to aid carpal tunnel patients. We will explore many studies looking at the effectiveness of manual therapy for this condition. These research articles are adapted from searches using the government’s primary health resource database, PubMed.gov. There are many reasons to emphasize research findings with manual therapy efforts. First, showcasing research that indicates the effectiveness of treatment validates anecdotal claims of manual therapy’s benefits. Second, highlighting research helps therapists persuade insurance companies to include manual therapy techniques in covered treatment. Third, the medical community respects legitimate research when considering manual therapy as a viable treatment endorsement option. Finally, the public will view manual therapy as a legitimate allopathic means of healthcare when research confirms the proposed benefits. “Massage Therapy as an Effective Treatment for Carpal Tunnel”; Elliot, R., & Burkett, B.; Journal of Bodywork and Movement Therapies , July 2013 Summary : This study investigated the effectiveness of massage therapy in treating carpal tunnel syndrome, a condition causing nerve pain in the hand. Researchers identified trigger points contributing to neuropathy and developed pressure tables to standardize treatment. Twenty-one participants received 30-minute massages twice a week for six weeks. Evaluations included carpal
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Book Code: MGA1226
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