NRG: Physiotherapy Beneficial For Carpal Tunnel Syndrome

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CAN PHYSIOTHERAPY BE BENEFICIAL FOR CARPAL TUNNEL SYNDROME?

Carpal Tunnel Syndrome (CTS) is a common condition that results in significant time loss at work, and has been reported to account for up to 50% of repetitive work related conditions 1. Prevalence rates have also been reported to range in the area of 6-12 percent of the general population 2 . CTS is an injury to the median nerve at the wrist Although much of the recent evidence has not shown substantial benefits of Physiotherapy for CTS, I feel muchofthatcanbeattributed to poor treatment programs that focus too specifically at the wrist without taking into consideration the whole path of the nerve. I came across an interesting study that examined the effects of Manual Therapy Vs Surgery

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on Self-Reported Function, Neck Range of Motion, and Pinch Grip Force in CTS. It was found in the study that when manual treatment was essentially directed along the entire path of the nerve from neck to wrist, those in the manual therapy group experienced superior improvements in self-reported function and pinch grip force compared to surgery at one month, with no differences between the surgery and physiotherapy outcomes at 3,6 and 12 months 6 . So what insights may this study provide? My take away was that although CTS is considered as compressive neuropathy at the wrist, much of the time many areas along the path of the nerve such as the neck and chest may also be contributing to the problem, and when we direct treatment to account to this, we achieve better outcomes. Bibliography 1.Szabo,RobertM."Carpal tunnel syndrome as a repetitivemotiondisorder."Clinicalorthopaedics and related research351 (1998):78-89. 2.Thiese,MatthewS., FredGerr,KurtT.Hegmann,CarisaHarris-Adamson,AnnMarieDale,BradleyEvanoff,EllenA.Eisen et al. "Effects of varying case definition on carpal tunnel syndrome prevalence estimates in a pooled cohort." Archivesofphysicalmedicineand rehabilitation95,no.12 (2014):2320-2326. 3. Marshall, Shawn C., Gaetan Tardif, and Nigel L. Ashworth. "Local corticosteroid injection for carpal tunnel syndrome."TheCochraneLibrary (2007). 4. Page, Matthew J., Nicola Massy‐Westropp, Denise O'Connor, and Veronica Pitt. "Splinting for carpal tunnel syndrome."TheCochraneLibrary (2012). 5. Page, Matthew J., Denise O'Connor, Veronica Pitt, and Nicola Massy‐Westropp. "Exercise and mobilisation interventions forcarpal tunnel syndrome."TheCochraneLibrary (2012). 6.Fernandez-De-Las-Penas,Cesar,JoshuaCleland,MaríaPalacios-Ceña,StellaFuensalida-Novo, Juan A. Pareja, and Cristina Alonso-Blanco. "The Effectiveness of Manual Therapy Versus Surgery on Self-reported Function,CervicalRangeofMotion,andPinchGripForce inCarpalTunnel An insurancedeductible is theamountofmoney thatyoumustpaybefore your insurancecompanypays foryourmedicalservices. Ifyourdeductible ismet,yourphysiotherapymaynotcostyouanything.Patientswith family plans or those who have had major surgeries or have a chronic illness are especially likely to have a $0 balance remaining on their out-of-pocket expenses.This means that the cost of physiotherapy could be minimal or completely covered by the patient’s insurance plan. If you are close to or have met your insurance deductible for the year, then now isthetimetocome inforphysiotherapy!Areyoufeelingaches&pains? Needtoworkonyourcore?Letushelpyougetaheadstartfor2018.Contact us today to schedule your appointment.

crease which generally causes decreased grip strength, pain, numbness or tingling into the thumb and first two digits.Up until recently there has been very little evidence to support the efficacy of Physiotherapy when it comes to conservative management of CTS, which commonly involves splinting, steroid injections, and wrist mobilization 3,4,5.

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