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Carpal Tunnel Syndrome

and the Role of Manual Therapy

— 23/02/25

Carpal Tunnel Syndrome (CTS) is a prevalent condition that affects millions of people worldwide, often impacting daily activities and reducing quality of life. Characterized by the compression of the median nerve as it passes through the carpal tunnel—a narrow passage in the wrist—CTS leads to symptoms such as numbness, tingling, weakness, and pain in the hand and fingers. Early diagnosis and treatment are essential for preventing long-term complications.
One of the emerging complementary treatments for CTS is manual therapy. Let’s explore how this approach can aid in managing symptoms and supporting recovery.

The Benefits of Manual Therapy for Carpal Tunnel Syndrome

Manual therapy involves hands-on techniques aimed at relieving tension, enhancing mobility, and promoting healing. While outcomes may vary, many patients experience relief with tailored manual therapy strategies. Here are some common techniques used in addressing CTS:

  1. Soft Tissue Mobilization
    This technique focuses on massaging and manipulating the soft tissues around the wrist and hand. It helps reduce muscle tightness, enhances flexibility, and may decrease the pressure on the median nerve.
  2. Nerve Gliding Exercises
    These gentle exercises promote better mobility of the median nerve. Improving the nerve's flexibility and movement within the carpal tunnel can alleviate discomfort and other symptoms of CTS.
  3. Joint Mobilization
    Mobilization of the wrist and hand joints can help increase the range of motion and reduce stiffness. By restoring joint movement, this technique enhances overall hand function and reduces strain on the carpal tunnel.
  4. Stretching Exercises
    Specific stretches targeting the wrist and forearm muscles can ease tension around the carpal tunnel, lowering the compression on the median nerve and providing relief.

A Comprehensive Approach to CTS Management

Although manual therapy offers significant benefits, it is most effective when integrated into a holistic treatment plan. Comprehensive management strategies for CTS may include:

  • Rest and Splinting: Using wrist splints to minimize movement and allow healing.
  • Targeted Exercise Programs: Strengthening exercises to improve hand and wrist stability.
  • Medical Interventions: Corticosteroid injections or surgical options may be necessary for severe cases.

Prevention and Ergonomic Best Practices

Manual therapy isn’t limited to treating CTS—it’s also a valuable preventive tool. Individuals engaged in repetitive hand movements or exposed to poor ergonomic conditions can reduce their risk by optimizing wrist position, improving posture, and incorporating regular hand and wrist exercises. Preventive manual therapy can maintain tissue flexibility and reduce strain before symptoms develop.

When to Seek Professional Help

If you are experiencing persistent symptoms of CTS, consulting a healthcare provider is crucial. A specialist can diagnose the condition accurately and recommend a personalized treatment plan. Early intervention can significantly improve outcomes, preventing symptom progression and long-term nerve damage.
By combining manual therapy with other medical and preventive strategies, individuals can better manage Carpal Tunnel Syndrome and protect the health of their hands and wrists for the long term.

Some videos and Exercises 

Note: These exercises seem simple and safe to me if done according to the instructions. However this is at the user's own risk:
 


References / further readings

Fernández-de-las-Peñas, C., Ortega-Santiago, R., Díaz, H.F.-S., Salom-Moreno, J., Cleland, J.A., Pareja, J.A. and Arias-Buría, J.L. (2019). Cost-Effectiveness Evaluation of Manual Physical Therapy Versus Surgery for Carpal Tunnel Syndrome: Evidence From a Randomized Clinical Trial. Journal of Orthopaedic & Sports Physical Therapy, 49(2), pp.55–63. doi: https://doi.org/10.2519/jospt.2019.8483.

Jiménez-del-Barrio, S., Cadellans-Arróniz, A., Ceballos-Laita, L., Estébanez-de-Miguel, E., López-de-Celis, C., Bueno-Gracia, E. and Pérez-Bellmunt, A. (2021). The effectiveness of manual therapy on pain, physical function, and nerve conduction studies in carpal tunnel syndrome patients: a systematic review and meta-analysis. International Orthopaedics, 46. doi: https://doi.org/10.1007/s00264-021-05272-2.

Kazantzidou, V., Lytras, D., Kottaras, A., Iakovidis, P., Kottaras, I. and Chatziprodromidou, I.P. (2021). The efficacy of manual techniques in the treatment of carpal tunnel syndrome symptoms: A narrative review. International Journal of Orthopaedics Sciences, [online] 7(2), pp.423–427. doi: https://doi.org/10.22271/ortho.2021.v7.i2f.2658

Talebi, G.A., Saadat, P., Javadian, Y. and Taghipour, M. (2020). Comparison of two manual therapy techniques in patients with carpal tunnel syndrome: A randomized clinical trial. Caspian Journal of Internal Medicine, [online] 11(2), pp.163–170. doi: https://doi.org/10.22088/cjim.11.2.163.

Wolny, T. and Linek, P. (2018). Is manual therapy based on neurodynamic techniques effective in the treatment of carpal tunnel syndrome? A randomized controlled trial. Clinical Rehabilitation, 33(3), pp.408–417. doi: https://doi.org/10.1177/0269215518805213.

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