As for most musculoskeletal disorders, carpal tunnel syndrome (CTS) treatment recommendations initially prescribe non-surgical or conservative management, for surgery being avoided only in emergency cases, or after non-surgical options. So, is there any way of knowing who would better respond to non-surgical approaches?
To reply to this, researchers performed a two-stage study that included an initial assessment followed by non-surgical treatment, and a one-year re-evaluation after completion of non-surgical treatment. The study’s primary objective was to determine factors that lead to the long-term effects of non-surgical CTS care and to identify risk factors for failure.
The study included 49 people diagnosed with CTS, of which 37 (76 percent) reported an occupational cause. Since some patients had CTS in both hands (bilateral CTS) this included a total of 78 hands / wrists in the study. Treatment included a total of 10 whirlpool massage sessions done at home to the wrist and neck, ultrasound, and median nerve glide exercises. The subjects were divided into three classes of age: < 50, 51-59, or around 60 years.
Although, in both stages of the study, most patients reported substantial change, some did not. Patients with more serious cases, as demonstrated by weak NCV test results, were less likely to respond to treatment, which highlights the importance of pursuing CTS treatment as soon as symptoms arise. In addition, participants who tended to overuse their hands at work, or who did not change their work procedures or workstation to minimise the forces applied to the hands and wrist, were less likely to show substantial changes at the point of one year. Interestingly, age was not found to be a major risk factor, which is surprising because previous studies have identified a risk factor being over 50 years old.
Not only are Osteopaths trained in the same non-surgical methods of treatment used in this research, but they may combine these techniques with dietary therapy (to minimise inflammation) and manual therapies to enhance function in the wrist and other locations along the path of the median nerve to obtain the best possible outcomes for their patients.