Non Surgical Treatment Approaches for CTS
Non surgical treatment approaches for carpal tunnel syndrome (CTS) aim to remove pressure on the median nerve where it’s pinched. In a recent review of the literature published on “passive modalities” (non-surgical treatment approaches) for CTS, researchers reviewed studies published between 1990 and 2015 for information on which non-surgical treatment approaches work best. Topping the list is the use of various types of night splints – wrist braces worn at night to prevent bending of the wrist during sleep. The evidence found that night splints were less effective than surgery in the short-term (up to six months) but more effective over the long-term (at 12 and 18 months)!
They did not find studies with a “low risk of bias” (no randomized controlled trial-types of studies) regarding other passive modalities such as ultrasound and electrical stim and hence, they conclude that better quality studies must be conducted before conclusions can be made regarding most of the passive modalities frequently utilized in the management of CTS.
A 2010 study found mobilization treatments and exercises (tendon gliding & nerve gliding) were helpful WHEN patients complied with the treatments and the recommended exercises. Manual therapies, or “hands-on” treatments, are a feature of chiropractic care. Chiropractic treatment for patients with CTS also includes night bracing in addition to manipulation, mobilization, exercise training, nutrition, and ergonomic / workstation modifications, and whole body health awareness.
Doctors of chiropractic understand these non-surgical approaches have limitations. This is why they work with allied healthcare providers when pharmaceutical and/or surgical intervention is appropriate. They may also frequently consult with neurologists for tests such as EMG/NCV (an electrical test that measures the degree of nerve damage) to better understand the patient’s condition. In short, chiropractic offers a multi-modal approach of care, and chiropractors will work with others in the patient’s best interest.