Carpal tunnel syndrome is the most prevalent peripheral nerve entrapment and presents a considerable challenge for workplaces and the Workers’ compensation system.
Carpal tunnel is characterised by neural symptoms such as tingling, numbness and weakness in the hand. Treatment is usually grouped into conservative and non-conservative options. Non-conservative treatment involves surgical release, which can result in significant time lost from work. Conservative treatment typically consists of splinting, massage, exercise and corticosteroid injections.
A new randomised controlled trial released in March this year in the Journal of Orthopaedic and Sports Physical Therapy has investigated the effectiveness of manual therapy versus surgery on self reported function, cervical range of motion and pinch grip force in Carpal Tunnel Syndrome.
100 women participated in the study, with 50 receiving conservative care consisting of 3 sessions of manual therapy and the other 50 receiving carpal tunnel release surgery.
The study found that the manual therapy group reported superior function and pinch grip force than the surgery group at one month follow up. There were no statistical differences in between the groups at 3, 6 and 12 month follow ups.
These results mirror a previous study completed in 2015 that also investigated manual therapy vs surgery for carpal tunnel syndrome. That study published in the journal Pain, found superior improvements in both pain and function and 1 and 3 months in the manual therapy group and no statistical difference in long term follow up.
These results may have significant implications. Early improvements in function are vital to assisting workers to get back to work or normal duties following injury. Therefore, early treatment of carpal tunnel syndrome with targeted manual therapy may result in superior benefits for both workers and workplaces.
It is vital for your business to encourage early reporting of symptoms so prompt early assessment, treatment and duty modification. Your workers should have access to experienced physiotherapists who practise manual therapy techniques. One way of achieving this is through an onsite physiotherapy program.
Fernández-de-las Peñas et. Al. The effectiveness of manual therapy versus surgery on self-reported function, cervical rnage of motion and pinch grip force in carpal tunnel syndrome: a randomized controlled trial. J Sports & Orthopaedic Physical therapy. 2017: 47(3): 151-161.
Fernández-de-las Peñas C, Ortega-Santiago R, de la Llave-Rincón AI, et al. Manual physical therapy versus surgery for carpal tunnel syndrome: a randomized parallel-group trial. J Pain. 2015;16:1087-1094