Rheumatology International

, Volume 33, Issue 5, pp 1233–1241 | Cite as

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

  • Susanna Maddali Bongi
  • Massimo Signorini
  • Massimo Bassetti
  • Angela Del RossoEmail author
  • Martina Orlandi
  • Giuseppe De Scisciolo
Original Article


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.


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


Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Susanna Maddali Bongi
    • 1
  • Massimo Signorini
    • 3
  • Massimo Bassetti
    • 1
  • Angela Del Rosso
    • 1
    Email author
  • Martina Orlandi
    • 1
  • Giuseppe De Scisciolo
    • 2
  1. 1.Division of Rheumatology, Department of Biomedicine, Denothe Centre, Careggi Hospital (AOUC)University of FlorenceFlorenceItaly
  2. 2.Neurophysiology Unit, Department of Neurology and PsychiatryCareggi Hospital (AOUC)FlorenceItaly
  3. 3.Center of Manual TherapyFlorenceItaly

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