Shop
Carpal Tunnel Syndrome: Non-invasive Treatments Gaining Traction
Carpal tunnel syndrome is the most common form of peripheral nerve compression worldwide. 1) A recent study shows the effectiveness of non-invasive treatments.
Carpal tunnel syndrome affects around 3-6% of adults 2), making it one of the most common nerve disorders. Predisposition, injury, inflammation, or water retention increase the risk of developing CTS.
People whose wrists are permanently under stress may be affected more frequently; this includes anyone who performs manual labour or adopts an unhealthy posture for a prolonged period while working at a computer keyboard.3)
© pathdoc | shutterstock.com
Carpal Tunnel Syndrome
The carpal tunnel is a small opening in the wrist bones that tendons, ligaments, and nerves pass through to the hand and fingers. The top of the carpal tunnel is formed by fibrous connective tissue called the carpal ligament (or flexor retinaculum).
One of the nerves passing through the carpal tunnel is the median nerve. The median nerve facilitates movement of the forearm, wrist, hand and fingers and provides feeling to the forearm and parts of the hand.
An injury to or inflammation in the wrist can narrow the carpal tunnel, squeezing the median nerve. A compressed median nerve can cause pain, numbness, or tingling in the wrist, hand, or fingers. Carpal tunnel syndrome does not commonly affect the pinky finger.
Left untreated, CTS can lead to loss of hand function.
Surgery is the Most Common Form of Treatment
The most common treatment for carpal tunnel syndrome is a surgery called carpal tunnel release.
During carpal tunnel release surgery, a surgeon severs the carpal ligament (flexor retinaculum) to create more room for the median nerve.
Although carpal tunnel release is widely used, the results of a 2022 study have shed light on the benefits of conservative treatments for carpal tunnel syndrome.
Review of International Research on Conservative Therapy for CTS
At the beginning of 2022, The Institute of Human Movement Science at the University of Hamburg published a review titled “Physiotherapy and sports therapeutic interventions for the treatment of carpal tunnel syndrome.” 4) Four hundred and sixty-one English and German language studies on the effectiveness of these methods were reviewed.
Spotlight on the Effectiveness of Physical and Sports Therapies for CTS
The study aimed to provide an overview of clinical studies on the effectiveness of physical and sports therapies for CTS compared to treatments like surgery.
Twenty-six of the studies included represent current research on non-invasive and non-drug therapies. The assessment criteria for these treatments were their effectiveness in relieving pain and improving hand functionality.
Studies Show
- Manual therapies for carpal tunnel syndrome are as effective as surgery
-
Despite the risks associated with surgery, it is the most common treatment for CTS
Read the Study
Gräf, J. K., Lüdtke, K., & Wollesen, B. (2022). Physio- und sporttherapeutische Interventionen zur Behandlung eines Karpaltunnelsyndroms : Eine systematische Übersichtsarbeit [Physiotherapy and sports therapeutic interventions for treatment of carpal tunnel syndrome: A systematic review]. Schmerz (Berlin, Germany), 36(4), 256–265. 
Manual CTS Therapies Are as Effective as Surgery.
The results were encouraging for manual therapies. Several studies reviewed show that manual therapies achieve positive results faster than surgery.
In some cases, the pain intensity and severity of symptoms were reduced, and the hand’s functionality improved after just two weeks of treatment. 5)6)7)
The long-term success (after about one year) of physical and sports therapies was comparable to successful surgery.
Liebscher & Bracht Exercises for Carpal Tunnel Syndrome
Liebscher & Bracht have developed exercises to treat carpal tunnel syndrome pain that you can do at home. The routines focus on stretching and massaging the muscles and fascia surrounding the carpal tunnel and hyperextending the wrist to improve and preserve mobility. Click below to discover Liebscher & Bracht’s Carpal Tunnel Exercises.
Discover Liebscher & Bracht's Carpal Tunnel Exercises
Up to 20% of People Who Have Carpal Tunnel Surgery Continue to Suffer Symptoms
Surgery isn’t necessarily the best option for CTS. Carpal tunnel release surgery is an invasive operation that can’t be reversed, strains the body, and leaves scars that can have a harmful after-effect. Often, patients are unable to work for up to two months after surgery.
© 1879854805_fizkes | shutterstock.com
Alternatives to Surgery
Many effective sports and manual therapies and treatments are available for carpal tunnel syndrome. These non-surgical options can be used in combination or on their own.
Combining Manual and Non-Invasive Treatments is Often More Effective Than a Single Treatment
Studies have been conducted to evaluate the effectiveness of combining non-surgical therapies. Undergoing physiotherapy and wearing a splint or applying kinesiology tape achieved better results than just one of these treatments.
Other Effective Treatments for Carpal Tunnel Syndrome
Treating the fascia (a layer of connective tissue throughout the body that surrounds and supports the muscles), joint mobilisation, massage, and yoga have been shown to improve carpal tunnel syndrome. Evidence suggests that laser and ultrasound treatments help reduce pain, but not as significantly as manual therapies.
The Benefits of Manual and Non-Invasive Treatments
Many of these options have been successful for years, making them treatment staples. The success and longevity of these treatments have proven that they are not inferior to surgery. Often, these options bring about improvements faster. Additionally, non-surgical treatments do not expose the patient to the risks associated with surgery, like infections and complications from scarring.
Long-term observation showed that non-surgical treatments for carpal tunnel syndrome achieved results equal to those of a successful surgery.
Since these treatment options are non-invasive and no physical trauma is inflicted, their significance is increasing.
Conclusion on Research
Most of the studies reviewed investigated follow-up care for carpal tunnel syndrome.
Studies have been done that show promising results for non-surgical treatments. However, the methodological inaccuracies of some of these studies limit their significance. More studies with careful methodology need to be conducted for longer to make more definite recommendations about non-surgical treatments.
Considering the scientifically proven success and limitations of manual therapies and non-invasive treatments for CTS, surgery should be chosen with caution.
Sources & Studies
- ↑1 Padua L, Coraci D, Erra C, Pazzaglia C, Paolasso I, Loreti C, Caliandro P, Hobson-Webb LD. Carpal tunnel syndrome: clinical features, diagnosis, and management. Lancet Neurol. 2016 Nov;15(12):1273-1284. doi: 10.1016/S1474-4422(16)30231-9. Epub 2016 Oct 11. PMID: 27751557.
- ↑2 Joshi A, Patel K, Mohamed A, Oak S, Zhang MH, Hsiung H, Zhang A, Patel UK. Carpal Tunnel Syndrome: Pathophysiology and Comprehensive Guidelines for Clinical Evaluation and Treatment. Cureus. 2022 Jul 20;14(7):e27053. doi: 10.7759/cureus.27053. PMID: 36000134; PMCID: PMC9389835.
- ↑3 Fernández-de-Las-Peñas, C., Cleland, J., Palacios-Ceña, M., Fuensalida-Novo, S., Alonso-Blanco, C., Pareja, J. A., & Alburquerque-Sendín, F. (2017). Effectiveness of manual therapy versus surgery in pain processing due to carpal tunnel syndrome: A randomized clinical trial. European journal of pain (London, England), 21(7), 1266–1276.
- ↑4 Gräf, J. K., Lüdtke, K., & Wollesen, B. (2022). Physio- und sporttherapeutische Interventionen zur Behandlung eines Karpaltunnelsyndroms : Eine systematische Übersichtsarbeit [Physiotherapy and sports therapeutic interventions for treatment of carpal tunnel syndrome: A systematic review]. Schmerz (Berlin, Germany), 36(4), 256–265.
- ↑5 Schmid, A. B., Elliott, J. M., Strudwick, M. W., Little, M., & Coppieters, M. W. (2012). Effect of splinting and exercise on intraneural edema of the median nerve in carpal tunnel syndrome--an MRI study to reveal therapeutic mechanisms. Journal of orthopaedic research : official publication of the Orthopaedic Research Society, 30(8), 1343–1350.
- ↑6 Wolny, T., & Linek, P. (2018). The Effect of Manual Therapy Including Neurodynamic Techniques on the Overall Health Status of People With Carpal Tunnel Syndrome: A Randomized Controlled Trial. Journal of manipulative and physiological therapeutics, 41(8), 641–649.
- ↑7 Wolny, T., & Linek, P. (2019). Is manual therapy based on neurodynamic techniques effective in the treatment of carpal tunnel syndrome? A randomized controlled trial. Clinical rehabilitation, 33(3), 408–417.
Discover the best exercises to treat your pain – for free!
Join over 2.5 million people worldwide who are already using our unique therapeutic techniques. Download our FREE PDF guide with 6 simple exercises for back pain and see the results for yourself!
Start your pain-free life now.