Friday, December 4, 2015

A manual form of physical therapy more effective than surgery for carpal tunnel syndrome

Most patients with condition want to avoid surgery

At Physical Therapy New Orleans, Carpal tunnel syndrome (CTS) is a painful disorder that occurs when a nerve in the wrist is compressed, and it affects up to 11.7% of the U.S. population.  Treatment for CTS may be either surgical or non-surgical (conservative), but the evidence for both options is conflicting.  Surgery for CTS has very high rates, but one study found that 61% of CTS patients would prefer to avoid surgery if possible.  Manual therapy, a form of physical therapy in which the therapist uses their hands to perform specific movements of joints, may be effective for treating CTS; however, no studies have investigated its use on CTS or compared it with surgery.  Therefore, a powerful study called a randomized-controlled trial was conducted that compared manual therapy to surgery for treating CTS.

Patients randomly assigned to one of two groups

A total of 200 women with CTS symptoms for at least one year were screened, and 120 satisfied all criteria and were randomly assigned to either the manual therapy or surgery group.  Patients in the manual therapy group received three 30-minute treatment sessions from a physical therapist once per week, which consisted of a series of mobilizations and nerve/tendon gliding exercises.  The surgery group underwent one of two procedures: either an open or endoscopic decompression and release of the carpal tunnel.  All patients were assessed for pain and function before the interventions and one, three, six and 12 months afterwards.

Effects are similar in long term, but manual therapy more effective in short term

Both groups experienced less pain and improved function at six and 12 months after treatment, but those in the manual therapy group experienced significantly greater relief of symptoms and improvements in hand function at one and three months.  This suggests that both treatments are equally effective in the medium-term and long-term, as more than 75% of patients attained success.  Based on these results, manual therapy is recommended as the first management option for CTS before considering surgery.  This is due to the fact that surgery is a more expensive approach with greater risk for complications, and because many patients prefer conservative treatment.  Doing so may reduce unnecessary surgeries, saving patients money while still treating them effectively.

-As reported in the August ’15 issue of The Journal of Pain

City Park Physical Therapy
5559 Canal Blvd
New Orleans, LA 70124
(504) 309-5811

Monday, November 2, 2015

City Park Physical Therapy

City Park Physical Therapy in New Orleans - Thoughts on Rehab, Life, and our community.