Carpal Tunnel Syndrome Treatment & Management

carpal tunnel treatment

Rehabilitation Program

Physical Therapy

Given that carpal tunnel syndrome (CTS) is associated with low aerobic fitness and increased BMI, it makes some inherent sense to provide the patient with an aerobic fitness and weight-loss program. Stationary biking, cycling, or any other exercise that puts strain on the wrists probably should be avoided.

The use of modalities (in particular therapeutic ultrasound) may provide short-term relief in some patients. [18, 19, 20] A study by Incebiyik et al indicated that in patients with mild to moderate CTS, treatment with short-wave diathermy (SWD) can produce significant short-term benefits, including alleviation of clinical symptoms and pain and improvement of hand function. In the prospective, randomized, controlled, double-blind trial, 31 patients (58 wrists) with mild to moderate CTS were treated with a combination of a hot pack, nerve and tendon gliding exercises, and either SWD or placebo SWD, undergoing this therapy five times per week for three weeks. A variety of evaluation measures, including the Tinel sign test,

Phalen sign test, carpel tunnel compression test, and Boston Carpal Tunnel Questionnaire (BCTQ) Symptom Severity and Functional Status scales, were used to assess patient outcomes. Significant improvements were found in the patients who underwent SWD but not in those who receivedthe placebo treatment. [21]

Additionally, yoga and carpal bone mobilization techniques have some weak evidence for reducing symptoms in the short term. [20, 22]

Occupational Therapy

Wrist splints with the wrist joint in neutral or slight extension (to be worn at nighttime for a minimum of 3-4 wk) have some evidence for efficacy. Certainly, they are low cost and have very low risk of adverse effects and therefore can be considered as an initial therapy. [23] No evidence suggests that a specific stretching/strengthening program for the hand and wrist is useful for treating carpal tunnel syndrome. [22] Massage and/or nerve-glide techniques offer no proven benefit. [20, 22] Work-site ergonomic assessment, equipment, and/or ergonomic positioning seem to not provide any benefit. [19, 24]

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