Comparative efficacy of conservative medical and chiropractic treatments for carpal tunnel syndrome: a randomized clinical trail.
OBJECTIVE
To compare the efficacy of conservative medical care with chiropractic care in the treatment of carpal tunnel syndrome.


METHODS
Two-group, randomized, single-blind trial with 9 wk of treatment and a 1-month follow-up interview.


METHODS
Wolfe-Harris Center for Clinical Studies at Northwestern College of Chiropractic in Bloomington, Minnesota.


METHODS
Ninety-one of 96 eligible subjects who reported symptoms that were confirmed by clinical exam and nerve conduction studies.


METHODS
Interventions included ibuprofen (800 mg 3 times a day for 1 wk, 800 mg twice a day for 1 wk and 800 mg as needed to a maximum daily dose of 2400 mg for 7 wk) and nocturnal wrist supports for medical treatment. Chiropractic treatment included manipulation of the soft tissues and bony joints of the upper extremities and spine (three treatments/week for 2 wk, two treatments/week for 3 wk and one treatment/week for 4 wk), ultrasound over the carpal tunnel and nocturnal wrist supports.


METHODS
Outcome measures were pre- and postassessments of self-reported physical and mental distress, nerve conduction studies and vibrometry.


RESULTS
There was significant improvement in perceived comfort and function, nerve conduction and finger sensation overall, but no significant differences between groups in the efficacy of either treatment.


CONCLUSIONS
Carpal tunnel syndrome associated with median nerve demyelination but not axonal degeneration may be treated with commonly used components of conservative medical or chiropractic care.
Davis
P T
PT
Northwestern College of Chiropractic, Bloomington, MN 55431, USA.
Hulbert
J R
JR
Kassak
K M
KM
Meyer
J J
JJ
D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D002349:Carpal Tunnel Syndrome / Q000188:drug therapy / Q000628:therapy*; D002684:Chiropractic; D005260:Female; D006801:Humans; D007052:Ibuprofen / Q000627:therapeutic use*; D008297:Male; D011482:Protective Devices; D012720:Severity of Illness Index; D016037:Single-Blind Method; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
D000894:Anti-Inflammatory Agents, Non-Steroidal; D007052:Ibuprofen