Carpal tunnel syndrome (CTS) is a common condition that affects around 6-12% of the population and can result in significant pain and disability. The financial costs associated with CTS can be staggering – ranging from $45,000 to $89,000 per patient over a six-year period when productivity losses are taken into account.
Historically, doctors and researchers have described CTS as the result of compression of the median nerve as it travels through the bony carpal tunnel at the wrist. However, there is recent evidence that CTS is a more complex pain syndrome with multiple studies showing women with CTS exhibit widespread pressure pain hypersensitivity, thermal pain increases, and what’s called “enhanced wind-up in extra-median nerve territories.” In other words, the central nervous system seems to be involved, affecting the whole body, not just the wrist and hand.
Traditionally, the management of CTS has included conservative interventions primarily focused on relieving wrist and hand symptoms using splints, manual therapies, modalities (ultrasound, laser), and exercise—with surgery recommended if the patient fails to respond to treatment. In looking at CTS as a product of the central nervous system (CNS), therapies that target desensitizing the nervous system may be more effective.
A 2017 randomized clinical trial compared manual therapy with surgery for improving BOTH pain and central sensitization (“nociceptive gain”) in CTS patients. Here, researchers randomly assigned 100 women to either a manual therapy group who received one session per week for three weeks including “desensitizing maneuvers of the CNS” or a surgical intervention group (50 in each group). The research team evaluated pressure pain thresholds (PPT), thermal pain thresholds (hot or cold – HPT or CPT), and pain intensity at baseline, three, six, nine, and twelve-month intervals following the intervention.
After one year, those in the manual therapy group experienced higher increases in PPT over the carpal tunnel at three, six, and nine months and greater decreases in pain intensity at three months than those who underwent a surgical procedure. Otherwise, the outcome measurements were similar for both groups.
The significance of this study supports that a non-surgical, manual therapy approach (in which chiropractic specializes) is more effective in the short term and equally effective in the long term as surgery for BOTH pain and central sensitization (PPT only – not HPT/CPT for either group).
So, if you are experiencing wrist pain, numbness, hand weakness, and carpal tunnel symptoms and you type in pain management near me, you may find Coast Chiropractic Centers with Dr. Timothy Harcourt, me, comes up.
You may wonder, “Do I need an MRI scan of my neck or wrist.”?
What is carpal tunnel syndrome?
You may have a “funny feeling like a numbness frequently called paresthesia. Even a handshake may be painful or weak. Some people have prescribed chemicals that may temporarily reduce the numbness but not fixing the problem. The numbing in the fingers can be annoying and even debilitating.
Also, if you feel arm pain it may indicate things are getting worse and may indicate a bulge on the disc or worse yet a herniated disc in your neck. Persistent or worsening pain intensity and/or frequency necessitates a visit to see a professional.
Call me, Dr. Tim Harcourt, at (239) 278-3344 and mention this article for an awesome discounted first visit to include history, exam, and adjustment or Class IV high-intensity laser treatment.
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