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).
CURRENT RESEARCH FINDINGS
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 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. “Response of Pain Intensity to Soft Tissue Mobilization and Neurodynamic Technique: A Series of 18 Patients with Chronic Carpal Tunnel Syndrome”; De La Llave-Rincon, A., Ortega-Santiago, R., Ambite-Quesada, S., Gil-Crujera, A., Puentedura, E. J., Valenza, M. C., & Fernandez De Las Penas, C.; Journal of Manipulative Physiology Therapy, July 2012 Summary: This prospective case series examined the effects of combining soft tissue mobilization and nerve slider neurodynamic techniques on pain and pressure sensitivity in
women with carpal tunnel syndrome (CTS). Eighteen women with CTS participated, and their pain levels and pressure sensitivity were assessed using the numerical pain rating scale (NPRS) and pain pressure threshold (PPT) testing at various anatomical sites. Assessments were conducted at baseline, immediately after treatment, and one week later. Results showed a significant decrease in current and worst hand pain intensity (p < 0.01) one week after treatment. PPT levels over the c5–c6 zygapophyseal joint increased significantly (p < 0.01), but no other significant changes in PPT levels were observed. The combined treatment reduced pain intensity but did not affect pressure pain sensitivity in these women with chronic CTS. “Massage Therapy Plus Topical Analgesic Is More Effective than Massage Alone for Hand Arthritis Pain”; Field, T., Diego M., & Solien-Wolfe, L.; Journal of Bodywork and Movement Therapy, July 2014 Summary: This study evaluated the effectiveness of massage therapy alone versus massage therapy combined with a topical analgesic for treating hand arthritis pain. Twenty adults were randomly assigned to either the massage-only group or the massage plus analgesic group. Both groups received weekly massages from a therapist and were taught to perform self-massage daily for four weeks. The massage plus analgesic group showed greater improvement in hand function and grip strength, and reductions in hand pain, depressed mood, and sleep disturbances compared to the massage-only group. This study suggests that combining massage with a topical analgesic may enhance the treatment of pain associated with hand arthritis. “Immediate and Long Term Effects of Selected Physiotherapy Methods in patients with Carpal Tunnel Syndrome”; Kwolek, A., & Zwolinka, J.; Ortopedia & Truamatolgia Periodical, November—December 2011 Summary: This study evaluated the immediate and long- term effects of a conservative treatment combining ultrasound therapy, massage, and kinesiotherapy for carpal tunnel syndrome (CTS). Sixty-one patients were assessed for symptoms such as pain, numbness, tingling, morning stiffness, and self-care difficulties. Tests included sensory impairments, autonomic disturbances, Luthy sign, and median nerve conduction studies. Hand joint range of motion and grip strength were measured before and after the rehabilitation program, with a follow-up one year later. Results showed significant improvements in symptoms, sensation quality, hand range of motion, and muscle strength. The study concluded that this combined therapy is effective for long-term management of CTS. “Evaluating the Pain Management Methods of Patients with Carpal Tunnel Syndrome”; Kızılcık Özkan, Z., Ünver, S., & Başar, A; Journal of the Turkish Society of Algology, October 2016 Summary: This descriptive study evaluated pain severity and management methods in patients with carpal tunnel syndrome (CTS). Conducted in a neurology clinic with 99 participants, data were collected using a patient data form, visual analog scale (VAS), and pain management inventory. Findings showed that 64.6% of patients experienced pain. To manage pain, patients used prescription medication, massage, and exercise, with exercise being reported as the most effective, followed by massage and then prescription medication. Healthcare professionals can use these findings to encourage the use of nonpharmacological pain management methods.
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Book Code: MFL1227
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