Conservative treatment of Carpal Tunnel Syndrome
Carpal tunnel syndrome (CTS) is due to compression of the median nerve and is the most commonly occurring compression neuropathy. Due to the varied etiopathogenesis of CTS, it remains a challenge for clinicians, as inadequate studies exist regarding conservative treatment. Based on the promising results of previous studies with manual therapy, the authors of the current study wanted to investigate the use of fascial manipulation (FM) versus low level laser therapy (LLLT) in the management of CTS. In general, it was shown that, while both LLLT and FM improve outcomes, FM had better long term effects than LLT.
Fascial manipulation is a manual therapy approach that focuses on deep muscle fasia. Evaluation and treatment of FM involves identifying specific points in the deep fascia that have tensional dysfunction and treating areas known as centers of coordination (COC). COC are points which are the convergence of vectorial forces of the myofascial units themselves.
42 patients were clinically and electroneuromyographically identified to have CTS and randomly assigned to either receiving FM or LLLT. Patients were evaluated before treatment, 10 days post treatment and 3 months post treatment. The Visual Analog Scale (VAS) and Boston Carpal Tunnel Questionnaire (BCTQ) were used to evaluate outcomes.
When comparing the results, it was shown that both LLLT and FM had a statistically significant improvement in pain and functional outcomes between pre-testing and 10 days post treatment. When considering the 3 month follow up, the subjects receiving laser treatment did not maintain the statistical significance of their outcomes, whereas those receiving manual therapy did. This study confirms that manual therapy is an appropriate intervention that may show long term benefits.
> From: Pratelli et al., J Bodyw Mov Ther 19 (2016) 113-118(Epub ahead of print). All rights reserved to Elsevier Ltd. Click here for the Pubmed summary.