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Health Update: Carpal Tunnel Syndrome

 

Carpal Tunnel Syndrome –

Chiropractic vs. Medical Treatment

 

            There are many patients who suffer from Carpal Tunnel Syndrome (CTS).  In fact, CTS is one of the most common work related injuries.  In spite of multiple studies that show the benefits of chiropractic treatment with patients suffering from CTS, many medical doctors are unaware of the studies and still tell their patients that chiropractic treatment is either ineffective, or may actually harm them.  This unsupported ill advice can easily result in the patient not even considering chiropractic care as a potential effective form of treatment.  This can be especially damaging to a patient who cannot tolerate anti-inflammatory medications such as Ibuprofen, Aleve, or aspirin.  In fact, side effects secondary to stomach pain (gastritis and/or ulcer) can be quite common, especially at the recommended dose of 2400 mg / day.  Moreover, if poor tolerance to these medications exists and a unsatisfying response to conservative medical treatment occurs, the “next step” offered to the patient may be surgery. Surgery that may have been avoidable had chiropractic treatment been considered.

 

            There are several studies available that will enlighten those who simply are not aware of the effectiveness of chiropractic care in the treatment of CTS.  In 1998, a 91 patient group was divided in half and treated for 9 weeks by either a non-surgical medical approach or by a chiropractic treatment approach. The medical approach included the use of 800 mg of Ibuprofen, 3x/day for 1 week, 2x/day for 1 week, and 800mg as needed to a maximum of 2400 mg/day dose for 7 weeks, as well as the use of a nighttime wrist splint.  The chiropractic group utilized manipulation of the bony joints and soft tissues of the spine and upper extremity for 3x/week for 2 weeks, 2x/week for 3 weeks, and 1x/week for 4 weeks, in addition to ultrasound over the carpal tunnel and a wrist splint at night.  It was reported that BOTH the medical and the chiropractic patient groups did equally well stating, “significant improvement in perceived comfort and function, nerve conduction and finger sensation.”

 

            In 2007, two different chiropractic approaches were compared and found to both be equally effective in improving nerve conduction, wrist strength, and wrist motion as well as patient satisfaction and daily activity function.  These improvements were maintained for 3 months in both groups equally as well.  Another study reported significant improvements in strength, range of motion, and pain after chiropractic treatment was given to 25 patients diagnosed with CTS.  The majority of the patients reported continued improvements for 6 months or more. There are other studies but I think the point is obvious – chiropractic treatment helps patients with CTS.

 

            The type of treatment that one may receive when being treated by a chiropractor includes manipulation of the bony joints of the neck and upper extremity.  Some soft tissue techniques are also very effective.  The objective of this is to improve the mobility of the joints and loosen the muscles through which the nerves pass, particularly, the median nerve that runs through the carpal tunnel and innervates the 2nd to 4th fingers. There are several exercises of both stretching and strengthening types that strive for similar goals.    Other modalities such as ultrasound, interferential current (IFC), ice massage/cupping over the tunnel, and others may also be utilized.  Nighttime wrist splints or braces also help to keep the wrist straight so that prolonged bending of the wrist at night is not possible.  There may be other treatment approaches that your chiropractic physician may suggest on an individual case basis.