Abstract Twenty adults were randomly assigned to a massage therapy or a massage therapy plus a topical analgesic application group. Both groups received a weekly massage from a therapist and were taught self-massage (same procedure) to be done by each participant once daily over a four-week period. The massage plus analgesic group as compared to the massage group had greater improvement in hand function as measured by a digital hand exerciser following the first session and across the four- week period. That group also had a greater increase in perceived grip strength and a greater decrease in hand pain, depressed mood and sleep disturbances over the four-week period. Massage therapy has been effective for several pain syndromes including migraine headaches (Lawler and Cameron, 2006), lower back pain (Hsieh et al., 2004), fibromyalgia (Kalichman, 2010), neck and shoulder pain (Kong et al, 2013), carpal tunnel syndrome (Elliot and Burkett, 2013) and pain related to upper limb arthritis (Field et al., 2013). The purpose of this current study was to determine whether applying a topical analgesic following massage might be more effective than massage alone in treating 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. Abstract Carpal tunnel syndrome is a serious therapeutic problem and is considerably impairs the patient’s quality of life. Despite many studies, the effectiveness of conservative treatment is still debatable. This study aimed to evaluate the immediate and long term effects of conservative treatment involving ultrasound therapy combined with massage and kinesiotherapy for carpal tunnel syndrome. A total of 61 patients were assessed with regard to such symptoms as pain, numbness, tingling sensation, morning stiffness and self-care difficulties. We used provocation tests and investigated sensory impairments, autonomic disturbances and Luthy sign. Conduction in the median nerve fibers was assessed during a nerve conduction study. We performed computer-aided measurement of the hand joint range of motion and global grip strength. The tests were conducted before and on completion of rehabilitation program. The hands were re-examined one year later. The treatment involved ultrasound therapy, massage and kinesiotherapy. The treatment outcomes confirmed the effectiveness of the therapeutic program. Significant improvements concerning the majority of the symptoms were observed between the first and second examination as well for the entire follow up period. We observed significant improvement in the quality of sensation, the hand range of motion and muscle strength. Ultrasound therapy combined with massage and kinesiotherapy brings the expected, long term effects of patients with carpal tunnel syndrome. “Evaluating the Pain Management Methods of Patients with Carpal Tunnel Syndrome”; Kizilcik-Ozkan Z., Unver S., Basar A.; Journal of the Turkish Society of Algology, October 2016 Abstract This study sought to evaluate pain severity and pain management methods of patients with carpal tunnel syndrome. Carpal tunnel syndrome is often confused with other conditions that manifest themselves in similar expected signs and symptoms. Thoracic outlet syndrome, Guyon’s canal syndrome, radial nerve impingement, pectoralis minor syndrome, frozen shoulder, and subscapular impingement are all conditions easily mistaken or deemed “carpal tunnel” by health professionals. Phalen’s test In Phalen’s test, the client presses the dorsal surfaces of the hands together in front of him/herself with his/her wrists flexed as much as possible. This position is held for up to 60
This descriptive study was conducted with patients who were diagnosed with carpal tunnel syndrome (n=99) in the neurology clinic of the university hospital between August 2014 and December 2015. Patient data form, visual analog scale (VAS) and a pain management inventory were used to collect data. Of the total, 64.6% of the patients experienced pain. Patients used prescription medication, massage and exercise to control pain, and reported that the most useful method was exercise followed by massage and finally prescription medication. Healthcare professionals may share the findings of the relative benefit according to method of pain management and encourage patients to use non-pharmacological methods. “Comparison of a Targeted and General Massage Protocol on Strength, Function and Symptoms associated with Carpal Tunnel Syndrome: a randomized pilot study”; Moraska, A., Chandler, C., Franklin, G., Edmiston-Schaetzel, A., Calenda, EL., Enebo, B.; Journal of Alternative and Complimentary Medicine, April 2008. Abstract Carpal Tunnel Syndrome (CTS) is a major, costly public health issue that could be dramatically affected by the identification of additional conservative care treatment options. Our study aimed to evaluate the effectiveness of two distinct massage therapy protocols on strength, function and symptoms associated with CTS. This was a randomized pilot study design with double pre- tests and subjects blinded to treatment group assignment. The setting for this study was a wellness clinic at a teaching institution in the United States. Twenty-seven subjects with a clinical diagnosis of CTS were included in the study. Subjects were randomly assigned to receive 6 weeks of twice weekly massage consisting of either a general (GM) or CTS targeted TM massage treatment program. Dependent variables included hand grip and key pinch dynamometers, Levine symptom and function evaluations, and the Grooved Pegboard test. Evaluations were conducted twice during baseline, 2 days after the 7th and 11th massages and at follow up visit 4 weeks after the 12th treatment. A main effect of time was noted on all outcome measures across the study time frame (P < 0.001). Improvements persist at least 4 weeks post treatment. Comparatively, TM resulted in greater gains in grip strength than GM (P = 0.04) with a 17.3% increase over baseline (P < 0.001) but only a 4.8% gain for the GM group (P = 0.21) significant improvement in grip strength was observed following the 7th massage. No other comparisons between treatment groups attained statistical significance. Both the GM and TM treatments results in improvement of subjective measures associated with CTS, but improvement in grip strength was only detected with the TM protocol. Massage therapy may be a practical conservative intervention for compression neuropathies such as CTS, although additional research is needed. Summary of research recommendations: ● Swedish (classic) massage. ● Trigger point therapy. ● Madenci massage technique. ● Soft tissue mobilization. ● Neurodynamic technique. ● Ultrasound therapy coupled with massage therapy. ● Targeted carpal tunnel massage protocols. seconds. The classic signs of CTS will manifest with this test if the condition is present. For true CTS patients, acute pain and sensation is felt within five seconds. This test can also be performed in reverse position (e.g. with wrists extended). Note: A positive indication with Phalen’s test performed with the wrist flexed indicates a bone/joint displacement injury. A positive indication with Phalen’s test performed with wrists extended indicates a myofascial-related challenge to address with the CTS patient.
DETERMINING IF A CLIENT HAS “TRUE” OR “FALSE” CTS
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Book Code: MLA1224
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