MANAGEMENT OF CARPAL TUNNEL SYNDROME WITH CONSERVATIVE MULTIMODAL THERAPY: A PROSPECTIVE CASE SERIES OF OUTCOMES WITH CONCURRENT WRIST AND CERVICAL MANIPULATION

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David Taylor

Keywords

Abstract

Background: There is limited research regarding the conservative management of carpal tunnel syndrome with combination of wrist and cervical manipulative therapy.  There is gap between common clinical practice and the literature-based evidence. This is a prospective observation case series of outcomes from a small group of carpal tunnel syndrome patients treated with both cervical and wrist manipulative therapy.


Clinical Features: This is a prospective case series involving the conservative management of patients diagnosed with carpal tunnel syndrome.


Intervention and Outcome: Patients received multimodal therapy, including a combination of manipulation of the cervical spine and wrist.  Eight patients (13 Carpal Tunnels) diagnosed by physical exam with carpal tunnel syndrome (CTS) and confirmed by electrodiagnostic tests, were treated with nonsurgical conservative care and outcomes were tracked over 10 weeks using the Carpal Tunnel Syndrome Questionnaire, electrodiagnostic testing, examination findings, and symptom resolution.


Conclusion: Multimodal conservative care for CTS, including a combination of cervical and wrist manipulation, provided favorable outcomes.  A high concordance rate of concurrent cervical complications of carpal tunnel syndrome is observed in the patients involved with this study. The Carpal Tunnel Functional outcome is proposed as a measuring tool related to Patient Oriented Evidence that Matters (POEMs) to evaluate the outcome of manipulative therapy for CTS. There is a need for further research to delineate the best conservative care for CTS.

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