Carpal Tunnel Syndrome: Part 3 - Treatment
Non-surgical physical therapy treatment
Patients that respond to non-surgical treatment tend to be those with less severe symptoms and those that do not have wasting of the thumb muscles. These treatments may include:
Hands on physical therapy treatment called manual therapy
Orthosis/splint - to immobilize the wrist in a near neutral position to maximize the size of the carpal tunnel and reduce the amount of tendon movement in the tunnel thereby reducing the swelling within the tunnel. The orthosis/splint is also worn at night during sleep.
Superficial heat and interferential current (an electrical stimulation machine) may give temporary relief
Ultrasound – there is conflicting evidence on the effectiveness of ultrasound for carpal tunnel syndrome
Advice to change aspects of a computer workstation if indicated. This may include modifications to place the wrist in a more neutral position, modifications to the keyboard to reduce the force required to strike the keys, and changes to the duration of using a mouse (alternate hands or change to touch screen)
Other treatments beyond the scope of this blog:
Other non-surgical treatments include steroid injections (not performed by a physical therapist). When non-surgical treatments fail or when symptoms are prolonged and severe, surgery may be recommended to release the carpal ligament.
Carpal Tunnel Syndrome Part 4 will cover the physical therapy manual treatment in more detail.
1. Carpal Tunnel Syndrome. American Academy of Orthopaedic Surgeons available at: https://orthoinfo.aaos.org/en/diseases--conditions/carpal-tunnel-syndrome/
2. Erickson M, Lawrence M, Stegink Jansen CW, et al. Hand pain and sensory deficits: Carpal tunnel syndrome. J Orthop Sports Phys Ther 2019; 49(5):CPG1-CPG85. Link: https://www.jospt.org/doi/full/10.2519/jospt.2019.0301