So often we hear, “…well if it’s so good, show me the proof!” Even though the chiropractic case management of CTS has been well-established for many years, we still hear skepticism from patients, MDs, insurers, employers, and others about its efficacy. 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 is that
chiropractic treatment was equally effective as medical treatment in
reducing CTS symptoms. In this study, 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) and the
use of a nighttime 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
Thirty-eight CTS sufferers received chiropractic
spinal manipulation and extremity adjusting, soft tissue therapy,
dietary modifications or supplements (vitamin B6), and were prescribed
daily exercises. After treatment, results showed improvement in all
strength and range of motion measures. Also, outcome assessments showed a
significant reduction in pain and distress ratings among participants.
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. They presented a case report of a man with both cervical
radiculopathy and carpal tunnel syndrome, i.e., “double crush syndrome”.
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 in this
paper. The presence of double crush syndrome helps explain why
cervical/neck manipulation helps many CTS patients.
