Carpal tunnel syndrome (CTS) is the most common peripheral neuropathy affecting approximately 4-5 percent of the general population and approximately 10 percent of working adults. Osteopathic care for patients with CTS usually requires many of the same treatments as those used for conditions such as neck and back pain, such as joint compression, relaxation, precise exercises, and dietary guidelines to minimise inflammation. In some cases, patients with pain in the neck and back may benefit from traction. Could the people suffering from CTS also take advantage of the traction applied to the wrist?
A Canadian journal published in 2004, reported a series of cases involving four patients with confirmed CTS who underwent a mechanic traction treatment method involving between five and twelve 5-minute treatment sessions over a 3-month period. The results showed a recovery in the nerve conductive tests that lasted up to one year after the end of treatment.
In a study published in October 2017, 181 CTS patients were assigned either mechanical traction (two therapies per week for six weeks) or regular medical therapy. The basis used by the researchers for a successful outcome was whether or not the patients had chosen to undergo carpal tunnel release surgery within the following six months.
According to the researchers, 43 per cent of participants in the usual care group were exposed to carpal tunnel surgery in the allocated time frame compared to only 25 percent of patients in the mechanical traction group. The researchers concluded that mechanical traction appeared to be an effective conservative treatment option for CTS patients. Treatment guidelines recommend that patients exhaust all non-surgical treatment options before considering surgery, unless otherwise justified.
However, as with any musculoskeletal problem, it is important to identify all the factors contributing to the main complaint of the patient. In the case of a suspected CTS, median nerve compression in the wrist may or may not occur. Likewise, median nerve compression can occur anywhere else along the course of the nerve from the neck to the hand. It is also possible to see non-musculoskeletal causes of swelling in the carpal tunnel that need to be addressed in conjunction with other health care professionals in order for the patient to achieve an adequate outcome.