So often we hear, “…well if it’s so good, show me the proof!” Chiropractic case management of CTS has been well established for many years. And yet, we still hear skepticism from patients, MD’s, insurers, employers, and others about the benefits of chiropractic management of CTS. If we can, “show them the data” regarding the effectiveness of chiropractic for CTS patients, we will finally be able to help more people with this potentially disabling condition.
So, let’s take a look at the evidence that supports the benefits of chiropractic for CTS:
1) Davis PT, Hulbert JR, Kassak KM, et al. “Comparative efficacy of conservative medical and chiropractic treatments for carpal tunnel syndrome: a randomized clinical trial”
J Manipulative Physiol Ther. 21.5 (June 1997): 317-326.
The most important finding reported in this 91 patient study was that chiropractic treatment was equally effective in reducing CTS symptoms as medical treatment. The chiropractic care included ultrasound, nighttime wrist supports and manipulation of the wrist, arm and spine. Medical care included ibuprofen (800 mg, 3x/day for 1 wk, 800 mg, 2x’day for 1 wk, & 800 mg as needed for 7 wks) plus a night wrist splint. Both groups did equally well but given the side-effect potential of ibuprofen on the stomach, liver, and kidneys, a strong argument for the non-drug, chiropractic approach can be made.
2) Bonebrake AR, Fernandez JE, Marley RJ et al. “A treatment for carpal tunnel syndrome: evaluation of objective and subjective measures” J Manipulative Physiol Ther. 13.9 (Nov-Dec 1990): 507-520
CTS sufferers (n=38) received chiropractic spinal manipulation and extremity adjusting. Also, soft tissue therapy, dietary modifications or supplements (B6) and daily exercises were prescribed. After treatment, results showed improvement in all strength and range of motion measures. Also, a significant reduction in pain and distress ratings was reported.
3) Mariano KA, McDougle MA, Tanksley GW “Double crush syndrome: chiropractic care of an entrapment neuropathy” J Manipulative Physiol Ther. 14.4 (May 1991):262-5
In 1973, Upton and McComas first proposed the presence of the “double crush syndrome.” Their hypothesis was that when a nerve is pinched anywhere along its route, it makes the rest of the nerve more sensitive to otherwise “normal” stimulation. A case report of a man with both cervical radiculopathy and carpal tunnel syndrome, i.e., “double crush syndrome” was presented. Chiropractic management consisted of chiropractic manipulative therapy as well as ultrasound, electrical nerve stimulation, traction and a wrist splint. The experimental basis, clinical evidence, etiology, symptomatology and findings of this condition are discussed. The Double Crush Syndrome helps explain why cervical/neck manipulation helps many CTS patients.