Carpal tunnel syndrome is a painful condition characterized by tingling, weakness, and numbness in the wrist and hand, and it is increasingly a reason patients seek out the expertise of a chiropractor. Traditional medical treatments include the use of wrist braces and anti-inflammatory medication, and if symptoms continue for longer than six-months, patients are often advised to consider surgery. Unfortunately, almost a third of patients who opt for surgery report a return of CTS symptoms within two years.
Chiropractors offer a non-surgical option for treatment of CTS, but to date scientific research into the effectiveness of chiropractic treatment for CTS has been limited. Researchers affiliated with the University of Quebec at Three Rivers conducted a randomized clinical trial investigating the results of ischemic compression therapy on 55 patients with chronic CTS and found that those who received the treatment experienced a significant improvement in their pain symptoms.
People who suffer from CTS often report that their pain peaks at night—sometimes enough to disrupt sleep patterns. During the initial consultation, researchers detected trigger points along the biceps and in the elbows of all the study participants. They hypothesized that reduced blood flow during the night while the body is at rest causes a build-up of lactic acid, and that this build-up increases irritation of the nerve that runs from the forearm to the hand. This could explain the relief people with CTS receive by "shaking out" their hands and wrists upon waking. The question was whether using targeted trigger point therapy to increase circulation in the arms of participants would result in a reduction in symptoms.
All of the study participants received a course of 15 chiropractic treatments over a period of 5 weeks. A total of 37 patients were randomly assigned to receive the experimental treatment, which consisted of pressure applied to the patient's identified trigger points in the biceps and elbow. The remaining 18 participants in the control group received similar treatment, but with pressure applied to areas of the collar bone and shoulder. After the initial 15 sessions, the control patients were offered the option of attending an additional 15 sessions, this time undergoing the experimental treatment. All patients completed a questionnaire about the severity of their symptoms both before and after treatments.
The patients who received the experimental treatment reported both a greater improvement in function and a greater reduction of pain symptoms than those in the control group. Those who received the experimental treatment reported their symptoms had improved by 67%, while the control group reported just a 50% improvement. These improvements lasted when the researchers followed up after one month. Control patients who opted for the crossover treatment subsequently reported a 75% improvement in symptoms.
Despite the study's small size, the researchers conclude that some targeted trigger point therapy may provide an effective and lasting solution for patients with CTS.
Hains G, Descarreaux M, Lamy AM, Hains F. A randomized controlled (intervention) trial of ischemic compression therapy for chronic carpal tunnel syndrome. Journal of the Canadian Chiropractic Association. 2010 September; 54(3): 155–163.
