A manual therapy intervention improves symptoms in patients with carpal tunnel syndrome: a pilot study.
In carpal tunnel syndrome (CTS), manual therapy interventions (MTI) reduce tissue adhesion and increase wrist mobility. We evaluated the efficacy of a MTI in relieving CTS signs and symptoms. Twenty-two CTS patients (pts) (41 hands) were treated with a MTI, consisting in 6 treatments (2/week for 3 weeks) of soft tissues of wrist and hands and of carpal bones. Pts were assessed for hand sensitivity, paresthesia, hand strength, hand and forearm pain, night awakening; Phalen test, thenar eminence hypotrophy and Boston Carpal Tunnel Questionnaire (BCTQ) Symptom Severity Scale (SSS) and Functional Status Scale (FSS). Median nerve was studied by sensory nerve conduction velocity (SNCV) and distal motor latency (DML). CTS was scored as minimal, mild, medium, severe and extreme. We considered as control group the same pts assessed before treatment: at baseline (T0a) and after 12 weeks (T0b). Pts were evaluated at the end of treatment (T1) and after 24-week (T2) follow-up. At T0b, versus T0a, forearm pain and Phalen test positivity were increased and hand strength reduced (p < 0.05). BCTQ-SSS and BCTQ-FSS scores improved at T1 versus T0b (p < 0.05) with the amelioration maintained at T2. At T1, the number of pts with paresthesia, night awakening, hypoesthesia, Phalen test, hand strength reduction and hand sensitivity was reduced with the lacking of symptoms maintained at T2 (p < 0.05). No changes in SNCV, DML and CTS scoring were shown. MTI improved CTS signs and symptoms, with benefits maintained at follow-up. Thus, it may be valid as a conservative therapy.
Division of Rheumatology, Department of Biomedicine, Denothe Centre, Careggi Hospital (AOUC), University of Florence, Villa Monna Tessa, viale Pieraccini 18, 50139 Florence, Italy.
Susanna
S
Maddali Bongi
Massimo
M
Signorini
Massimo
M
Bassetti
Angela
A
Del Rosso
Martina
M
Orlandi
Giuseppe
G
De Scisciolo
D000368:Aged; D000704:Analysis of Variance; D001696:Biomechanical Phenomena; D002349:Carpal Tunnel Syndrome / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D018737:Hand Strength; D006801:Humans; D007558:Italy; D008297:Male; D008475:Median Nerve / Q000503:physiopathology; D008875:Middle Aged; D026201:Musculoskeletal Manipulations / Q000009:adverse effects; D009431:Neural Conduction; D009460:Neurologic Examination; D010146:Pain / Q000209:etiology / Q000517:prevention & control; D010147:Pain Measurement; D010349:Patient Compliance; D017060:Patient Satisfaction; D010865:Pilot Projects; D011237:Predictive Value of Tests; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012720:Severity of Illness Index; D012893:Sleep Wake Disorders / Q000209:etiology / Q000628:therapy; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D014955:Wrist Joint / Q000503:physiopathology