Original Article

Rheumatology International

, Volume 33, Issue 5, pp 1233-1241

First online:

A manual therapy intervention improves symptoms in patients with carpal tunnel syndrome: a pilot study

  • Susanna Maddali BongiAffiliated withDivision of Rheumatology, Department of Biomedicine, Denothe Centre, Careggi Hospital (AOUC), University of Florence
  • , Massimo SignoriniAffiliated withCenter of Manual Therapy
  • , Massimo BassettiAffiliated withDivision of Rheumatology, Department of Biomedicine, Denothe Centre, Careggi Hospital (AOUC), University of Florence
  • , Angela Del RossoAffiliated withDivision of Rheumatology, Department of Biomedicine, Denothe Centre, Careggi Hospital (AOUC), University of Florence Email author 
  • , Martina OrlandiAffiliated withDivision of Rheumatology, Department of Biomedicine, Denothe Centre, Careggi Hospital (AOUC), University of Florence
  • , Giuseppe De SciscioloAffiliated withNeurophysiology Unit, Department of Neurology and Psychiatry, Careggi Hospital (AOUC)

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Abstract

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.

Keywords

Carpal tunnel syndrome Manual therapy intervention Rehabilitation Conservative treatments Nerve conduction studies