Do You Need Surgery for Carpal Tunnel Syndrome?
Carpal tunnel syndrome (CTS) is a common condition with an estimated incidence of 542 per 100,000. Is surgery necessary with carpal tunnel syndrome? In this blog we go over a recent study that looked at the effects of manual therapy versus surgery.
When managing CTS, surgery and conservative approaches such as physical or occupational therapy are most commonly used. However, surgery continues to be the treatment approach most commonly used for CTS.
A study conducted in 2020 by Fernández-de-las-Peñas et al. followed 120 women with CTS who were randomly grouped to have either manual therapy or surgery.
The manual therapy group received 3 sessions of physical therapy which included desensitization techniques, soft tissue mobilization techniques in the areas of potential nerve entrapment of the median nerve, lateral glide mobilization of the cervical spine, and tendon/nerve gliding exercises. The surgical group received a carpal tunnel release procedure combined with a tendon/nerve gliding home exercise program. The participants were assessed at baseline, 1 year, and at 4 years after their intervention. Pain intensity, functional status, symptom severity, and self-perceived improvement were then measured using a global rating of change scale.
The study concluded that manual therapy resulted in better short-term and similar long-term effects on pain intensity and related-function than surgery.
To answer the title of this blog, surgery may not be needed for carpal tunnel syndrome based on this study. Manual therapy can be considered a first-line treatment option for CTS as it is equally effective of surgery.
Written by Daniel Le, DPT
References
César Fernández-de-las-Peñas, José L Arias-Buría, Joshua A Cleland, Juan A Pareja, Gustavo Plaza-Manzano, Ricardo Ortega-Santiago, Manual Therapy Versus Surgery for Carpal Tunnel Syndrome: 4-Year Follow-Up From a Randomized Controlled Trial, Physical Therapy, Volume 100, Issue 11, November 2020, Pages 1987–1996, https://doi.org/10.1093/ptj/pzaa150