Treating Carpal Tunnel Syndrome with Massage
Carpal tunnel syndrome (CTS) is a condition caused by compression of the median nerve located at the wrist. It usually results from overuse of the hands and wrists and is often associated with workers who spend a great deal of time repeating the same hand motions and wrist-flexing day after day, such as those who type or work on an assembly line. It is estimated that CTS affects 3.8%-9% of adult women and 0.6% of adult men. However, certain occupational populations are far more prone. For example, meat packers have been shown to have a 21% risk of having CTS.
Surgery is commonly prescribed for patients with chronic CTS. However, research has repeatedly demonstrated that surgery carries risks of adverse symptoms and that at least one-third of patients experience a return of CTS within two years of their operations.
Scientific studies have shown that CTS can be effectively treated by chiropractic methods such as cervical spine adjustments, soft tissue mobilization, and trigger point therapy. Researchers recently highlighted massage therapy as another noninvasive method of relieving CTS, in a study published in the Journal of Bodywork & Movement Therapies. Their goal was to evaluate the efficacy of massage therapy for treating CTS.
The study included 21 patients who were diagnosed with CTS. All participants received two massage sessions each week, each lasting 30 minutes, for a total of six weeks. The researchers analyzed the effectiveness of the treatment using carpal tunnel questionnaires and various medical tests. These included the Phalen test, whereby the back of the patient's hands are compressed together for one minute, and a test called Tinel's sign, in which patients are asked about wrist tingling after being subjected to light tapping on the median nerve. Researchers also identified the locations of trigger points in the hand that are associated with the disorder and designed a plan of massage pressures and trigger-point therapy for treatment.
Because trigger points can exacerbate the symptoms of CTS in some people, researchers included all possible sites of entrapment in each patient's comprehensive treatment plan. A remedial massage therapist used the following techniques on participants' muscles and ligaments in their hands, wrists, necks, forearms, and shoulders in each session:
- Effluerage: Smooth flowing strokes to relax muscles and promote blood flow
- Retrissage: Kneading and squeezing the muscles to reduce soreness and swelling and release adhesions
- Friction: Brisk circular or linear strokes to decrease inflammation and release scar tissue, increase circulation, and deactivate trigger point patterns.
The researchers found that massage reduced patients' CTS pain scores by an average of 68%. Participants also experienced a drastic 79% improvement in functional status. These results showed a higher success rate than previous research associated with surgery or massage alone. This led researchers to point to the benefit of including specific trigger point therapy into the massage treatment protocol.
They also highlighted the benefit of massage's noninvasive approach for treating CTS pain without dissecting the transverse carpal ligament, as surgery does. This often results in post-operative complications such as pain, numbness, scar tenderness, and weakened grip. Using a therapist's capable hands instead of a scalpel eliminated these treatment symptoms.
Elliot R, Burkett B. Massage therapy as an effective treatment for carpal tunnel syndrome. Journal of Bodywork & Movement Therapies 2013;1 7: 332-338/