International Journal of Advanced Research and Publications (2456-9992)

Manual Therapy Interventions For Carpal Tunnel Syndrome: A Review

Volume 3 - Issue 6, June 2019 Edition
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Author(s)
N.D.P.U. Nakandala
Keywords
Hand Grip Strength, median nerve, conservative treatments, numbness
Abstract
Carpal Tunnel Syndrome (CTS) is a debilitating condition which affects majority of the middle aged people in the community. This condition is predominant in females than the males. The condition may be affecting the patient’s single hand (unilateral) or both hands (bilateral). The functional outcomes are very poor and patient may be deteriorating psychologically as well. Signs and symptoms of the CTS can be varied from mild to moderate to severe. This includes numbness or paresthesia along the distribution of the median nerve of hand, pain, atrophy of muscles, reduced hand grip strength etc. The people who are experiencing mild or moderate symptoms usually seek for conservative therapies including elctro therapeuatic modalities and manual therapy techniques. When the condition becomes chronic, the concern is more towards the surgical approaches that involves the carpal tunnel release and thereby releasing the median nerve compression. But majority of the patients with CTS are reluctant to follow the surgical interventions. This is mainly due to economic problems and secondary complications of the surgery. Therefore the evaluation of the effectiveness of the conservative therapies should be a major concern which are cost effective and lack of secondary complications. Many research have been conducted to see the efficacy of various conservative therapies. This includes electrotherapeutic modalities, manual therapy interventions, oral supplements and medications, wrist immobilizations such as with splints so on. Among all the aforementioned therapies, manual therapy interventions alone are known to be more effective in treating CTS. There are various manual techniques with primary focus on reducing the compression on median nerve and thereby inducing the optimum gliding of the nerve in the carpal tunnel. This is done by stretching the adhesions developed between the median nerve and the surrounding structures, removing the myofascial restrictions, improving the pliability and flexibility of the flexor tendons by eliminating the inflammation of the tendon sheaths. In summary this review focus on research which are conducted to evaluate the efficacy of manual therapy interventions in treating the CTS. Since a combination of various techniques is more advantageous than a single treatment alone, emphasis should be given to develop a protocol including manual therapy techniques with other conservative modalities in rehabilitating the patients with CTS.
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