Physical therapy could be just as effective as surgery in treating carpal tunnel syndrome (CTS), says a new study conducted by scientists at the King Juan Carlos University in Spain.
Carpal tunnel syndrome occurs when the median nerve, which runs from the forearm into the palm of the hand, becomes squeezed at the wrist. It often arises from repetitive motions required for work, such as computer use or assembly line work.
Researchers behind the new study said that physical therapy, especially the so-called manual therapy, improved hand and wrist function and reduced pain as effectively as a standard operation for the condition.
Moreover, after one month, physical therapy patients reported better results than those who underwent surgery.
The team behind the study suggested that physical therapy should be the first therapeutic option for almost all patients with CTS. If conservative physical therapy fails, then surgery could be the next option, they added. An added benefit of therapy over surgery is the huge savings in cost.
Symptoms of CTS usually start gradually, with patients noticing numbness and weakness in the hand and wrist. Surgery for the condition generally involves cutting a ligament around the wrist to reduce pressure on the median nerve.
Surgery is especially recommended when there is muscle weakness or atrophy from the nerve being compressed at the wrist. However, operations can have their own complications. Studies show that approximately 25 percent of individuals undergoing surgery for carpal tunnel syndrome experience treatment failure with half of those requiring an additional surgical procedure.
For their study, the researchers in Spain observed 100 women who suffered from carpal tunnel syndrome. Half of them underwent physical therapy while the other half had surgery to rectify their problem.
For three weeks, the therapy patients received weekly half-hour manual therapy sessions — meaning therapists only used their hands. The therapists focused on the neck and the median nerve. They also applied manual physical therapy to the shoulder, elbow, forearm, wrist and fingers. On their own, patients performed neck-stretching exercises at home.
After one month, the therapy group reported greater daily function and greater ‘pinch strength’ between the thumb and forefinger compared to the surgery patients. After three, six and 12 months, however, improvements were similar in both groups. All participants experienced similar reductions in pain.
While the study was not conclusive as it included only women, the team recommended that manual physical therapy techniques should become a standard of practice for physical therapists working with patients who have carpal tunnel syndrome.
According to the researchers, almost half of all work-related injuries are linked to carpal tunnel syndrome. And, more than one-third who undergo surgery for the condition are not back at work eight weeks later.