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Carpal tunnel syndrome: physical therapy vs surgery

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Carpal tunnel syndrome (CTS) can be treated with physical therapy or surgery, and a new study suggests that both options are just as effective.

Researchers in Spain and the United States found that one year after treatment, patients with CTS who received physical therapy achieved results comparable to outcomes for patients who had surgery for the condition. What’s more, the physical therapy patients saw faster improvements at the one-month mark than those who were treated surgically.

CTS is a condition that causes a tingling sensation, numbness and pain in the hand and fingers. It is caused by compression of the median nerve, which controls sensation and movement in the hands.

The new research, published in the Journal of Orthopaedic & Sports Physical Therapy, involved 100 women with carpal tunnel syndrome who were randomly selected to receive either physical therapy or surgery. The results showed that at three, six and 12 months following treatment, both groups had similar improvements in function and grip strength. Pain also decreased similarly for patients in both groups.

This demonstrates that physical therapy — particularly a combination of manual therapy of the neck and median nerve and stretching exercises — may be preferable to surgery, certainly as a starting point for treatment, the researchers said.

Last year, a study published in the Journal of Hand Surgery suggested that people who have surgery for CTS regain their typing ability within two to three weeks.

But in the new study more than a third of patients did not return to work within eight weeks of the operation.

The researchers noted, however, that because the study only included women from a single hospital, further research needs to be done to generalise the findings. There was also no available data on the most effective dosage for the manual therapy protocol applied.