While the primary driver for carpal tunnel syndrome (CTS) may sometimes be hormonal changes (hypothyroid, pregnancy, or birth control use), type 2 diabetes, or an inflammatory condition (rheumatoid arthritis, psoriatic arthritis, or gout), many patients’ hand and wrist symptoms are caused by musculoskeletal issues that place pressure on the median nerve or restrict its motion. The good news is that chiropractic care is a great fit for the CTS patient, but how much care is needed before the numbness, tingling, weakness, and pain starts to resolve?
In one study that included 22 CTS patients, 19 of whom had CTS in both hands and wrists, researchers observed that the application of only manual therapy techniques to the hand, wrist, and forearm three times a week for two weeks led to significant improvements in pain, function, numbness, sensation, strength, and night awakening. The patients also performed better on the Phalen’s maneuver—a common clinical test used to stimulate CTS symptoms. Best of all, the participants continued to experience these improvements up to twelve weeks after their final treatment!
In addition to the manual therapies involved in the aforementioned study, doctors of chiropractic utilize additional non-surgical techniques such as nocturnal wrist splinting, at-home exercises/stretching, nutritional counseling, and job/ergonomic modifications. Dysfunction elsewhere along the course of the median nerve (such as the neck, shoulder, elbow, and forearm) may also need to be addressed.
If non-musculoskeletal causes are suspected, co-management with the patient’s medical doctor may be necessary. Though several studies have shown that surgical intervention may not be superior to non-surgical care over the long-term, a referral to a surgeon may be warranted if non-surgical treatment fails to produce a satisfying result.
For CTS and other musculoskeletal conditions, many doctors of chiropractic will commence care with a short-term approach (such as six visits spread over two weeks, as used in the study discussed above) to evaluate how the patient responds to care and to adjust treatment recommendations from there. In mild cases, the patient may be released from care and advised to return on an as-needed basis. For chronic or severe cases of CTS, additional treatment may be required, though if the condition is too advanced, a full resolution of symptoms may not be possible. Hence, the importance of visiting your doctor of chiropractic for hand and wrist symptoms sooner rather than later!