By: Dr. Abe Kopolovich, DPT, MBA

PHYSICAL THERAPY, NOT SURGERY, SHOULD BE THE FIRST OPTION FOR ALMOST EVERY PATIENT

Back surgery is the only kind of musculoskeletal surgery that is more common than carpal tunnel surgery.

The above sentence sounds wrong, but it isn’t. The Bureau of Labor Statistics and the Occupational Safety & Health Administration reported that about 8 million Americans suffer each year from carpal tunnel syndrome and about 230,000 of them had carpal tunnel surgery annually from 2007 through 2014.

It turns out, though, that “almost all patients with this condition” should have chosen physical therapy rather than surgery, the lead author of a study by King Juan Carlos University in Spain involving 50 carpal tunnel syndrome patients who had physical therapy and 50 who had surgery told WebMD in an article entitled “Physical Therapy Equals Surgery for Carpal Tunnel.”

“Researchers found that physical therapy – particularly so-called manual therapy – improved hand and wrist function and reduced pain as effectively as a standard operation for the condition,” the article reported. “Moreover, after one month, physical therapy patients reported better results than those who underwent surgery.”

The world-renowned Cleveland Clinic describes carpal tunnel syndrome as a medical condition that occurs when the median nerve that runs from the forearm to the hand via a narrow space called the carpal tunnel becomes compressed or pinched and, thus, causes numbness, tingling, and pain in the hand and fingers.

Medical professionals have for decades often recommended surgery when carpal tunnel syndrome becomes severe, but the study in Spain showed that patients who received massage therapy on their elbow, fingers, forearm, median nerve, neck, shoulder, and wrist for 30 minutes per week for one month and also did neck stretching exercises at home “reported greater daily function and greater pinch strength between the thumb and forefinger compared to the surgery patients.” The results of therapy and surgery after three, six, and 12 months were similar.

The kinds of physical therapy that worked in Spain – massages and stretching – are two examples of non-surgical alternatives for carpal tunnel syndrome patients. Below is a closer look at five physical treatments for carpal tunnel syndrome.

It turns out, though, that “almost all patients with this condition” should have chosen physical therapy rather than surgery, the lead author of a study by King Juan Carlos University in Spain involving 50 carpal tunnel syndrome patients who had physical therapy and 50 who had surgery told WebMD in an article entitled “Physical Therapy Equals Surgery for Carpal Tunnel.”

1. MASSAGE THERAPY

The article about the study in Spain did not detail the kind of massage therapy that carpal tunnel syndrome patients received, but the article “Massage Therapy for Carpal Tunnel Syndrome” lists five techniques. They are compression, cross-fiber function, deep tissue work, stretching, and trigger point. Massage therapy reduces pain, improves grip strength, and makes muscles more flexible, the article reports

2. STRETCHING EXERCISES

The Healthline article “Exercises for Treating Carpal Tunnel” recommends several stretching exercises, including the “Stretch armstrong.” This exercise entails placing your arms in front of you one at a time, spreading your fingers and then “stretching your wrist and fingers as far as you’re able” and then holding that position for 20 seconds. In addition, you can do basic wrist stretches that include bending your hand toward you so your fingers point up toward the ceiling, reports the WebMD article “What Exercises Help for Carpal Tunnel Syndrome?”

3. STRENGTH EXERCISES

“What Exercises Help for Carpal Tunnel Syndrome” lists several strength exercises. To strengthen your hands and grip, do the hand squeezes exercise, which consists of squeezing a soft rubber ball or rolled-up socks and then holding the squeeze position for five seconds. The article recommends 10 repetitions three times daily. For your wrists, do the wrist curl, which entails bending your wrist 30 times daily while your arm is bent like the letter L, and a wrist resistance exercise that entails raising one hand up while the other hand tries to keep it down.

4. MOVEMENT EXERCISES

“Tendon Gliding” and “Nerve Gliding” are movement exercises WebMD recommends in its exercise article. The tendon exercise consists of moving fingers through many different positions including curling them inward until they’re bent at the middle knuckles and straightening them so your hand is shaped like an L. The nerve exercise consists of moving parts of your hand and wrist into many positions. Straightening your fingers out so they point up is part of one exercise. Another consists of bending your wrist so your fingertips are pointed away from you.

5. HEAT AND ICE

Heat treatment is included in most definitions of physical therapy. The Cleveland Clinic’s “5 Ways You Can Ease Carpal Tunnel Syndrome Pain Without Surgery” include immersing your affected hand or hands in water that is between 92 and 100 degrees and moving your hand and wrist while they’re underwater. Another recommendation by the Cleveland Clinic — “Ice your wrist or soak it in an ice bath for 10 minutes to 15 minutes once or twice an hour.”

 

Everyone’s condition is different and, thus, a different solution will work for different people. Consult with a physical therapist before consenting to surgery. The medical research shows that physical therapy is beneficial for millions of people. “The goals of physical therapy are to reduce your symptoms without the need for surgery, to enable you to be as active and functional as possible, and to help you resume your normal work, home, and leisure activities,” says the “Physical Therapist’s Guide to Carpal Tunnel Syndrome.”