Chuna Manual Therapy for Carpal Tunnel Syndrome: A Systematic Review

Abstract Aim of the study Systematic review and meta-analysis to assess the effectiveness of manual therapy in improving carpal tunnel syndrome (CTS) symptoms, physical function, and nerve conduction studies. Method MEDLINE, Web of Science, SCOPUS, Cochrane Library, TRIP database, and PEDro databases were searched from the inception to September 2021. PICO search strategy was used to identify randomized controlled trials applying manual therapy on patients with CTS. Eligible studies and data extraction were conducted independently by two reviewers. Methodology quality and risk of bias were assessed by PEDro scale. Outcomes assessed were pain intensity, physical function, and nerve conduction studies. Results Eighty-one potential studies were identified and six studies involving 401 patients were finally included. Pain intensity immediately after treatment showed a pooled standard mean difference (SMD) of − 2.13 with 95% confidence interval (CI) (− 2.39, − 1.86). Physical function with Boston Carpal Tunnel Syndrome Questionnaire (BCTS-Q) showed a pooled SMD of − 1.67 with 95% CI (− 1.92, − 1.43) on symptoms severity, and a SMD of − 0.89 with 95% CI (− 1.08, − 0.70) on functional status. Nerve conduction studies showed a SMD of − 0.19 with 95% CI (− 0.40, − 0.02) on motor conduction and a SMD of − 1.15 with 95% CI (− 1.36, − 0.93) on sensory conduction. Conclusions This study highlights the effectiveness of manual therapy techniques based on soft tissue and neurodynamic mobilizations, in isolation, on pain, physical function, and nerve conduction studies in patients with CTS.

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Faculty Opinions recommendation of Effectiveness of oral pain medication and corticosteroid injections for carpal tunnel syndrome: A systematic review.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.732999069.793575249 ◽

2020 ◽

Author(s):

César Fernández de las Peñas

Keyword(s):

Systematic Review ◽

Carpal Tunnel Syndrome ◽

Carpal Tunnel ◽

Pain Medication ◽

Oral Pain ◽

Tunnel Syndrome ◽

Oral Pain Medication ◽

Corticosteroid Injections

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Platelet-rich plasma in non-operative management of mild to moderate carpal tunnel syndrome – A systematic review & meta-analysis of short-term outcomes

Journal of Orthopaedics ◽

10.1016/j.jor.2021.05.004 ◽

2021 ◽

Author(s):

Martin S. Davey ◽

Matthew G. Davey ◽

Eoghan T. Hurley ◽

J. Tristan Cassidy ◽

Hannan Mullett ◽

...

Keyword(s):

Systematic Review ◽

Carpal Tunnel Syndrome ◽

Carpal Tunnel ◽

Platelet Rich Plasma ◽

Meta Analysis ◽

Operative Management ◽

Short Term ◽

Tunnel Syndrome ◽

Non Operative Management

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Carpal Tunnel Syndrome: A National Survey to Monitor Knowledge and Operating Methods

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18041995 ◽

2021 ◽

Vol 18 (4) ◽

pp. 1995

Author(s):

Valentina Scalise ◽

Fabrizio Brindisino ◽

Leonardo Pellicciari ◽

Silvia Minnucci ◽

Francesca Bonetti

Keyword(s):

Carpal Tunnel Syndrome ◽

Manual Therapy ◽

Carpal Tunnel ◽

Signs And Symptoms ◽

Current Evidence ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Therapeutic Exercises ◽

Chi Squared ◽

Tunnel Syndrome

The aim of this article was to investigate the knowledge, management, and clinical practice of Italian physiotherapists concerning patients with carpal tunnel syndrome (CTS). A national cross-sectional survey consisted of 24 questions was administered from December 2019 until February 2020. A Chi-squared independence test was run to study any difference between subgroups of the sample and responses to the questionnaire. Five hundred and eight respondents completed the survey. Most respondents (n = 225/508; 44.3%) are under 29 years old, female (n = 256/508; 50.4%) and have been working as physiotherapists for less than 5 years (n = 213/508; 41.9%). Most of respondents correctly knows about the cause (n = 455/508, 89.6%), main signs and symptoms of CTS (n = 415/508, 81.70%) and administer education, manual therapy, myofascial techniques and therapeutic exercises (n = 457/508, 89.88%). Three hundred and sixty-four (71.68%) respondents were aware of the influence of psychosocial factors on the patient’s outcomes. The survey showed greater adherence to evidences by physiotherapists holding a master’s degree. The results are mostly comparable with other surveys structured all over the world on the same topic. Italian physiotherapists management of the CTS was not always in line with current evidence. Interventions such as education, manual therapy, therapeutic exercise, nerve and tendon glide techniques are widely used, while the orthotic is only offered by half of the sample.

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Systematic review and meta-analysis of surgical options for recurrent or persistent carpal tunnel syndrome: simple decompression versus coverage of the median nerve

Journal of Hand Surgery (European Volume) ◽

10.1177/17531934211001715 ◽

2021 ◽

pp. 175319342110017

Author(s):

Saskia F. de Roo ◽

Philippe N. Sprangers ◽

Erik T. Walbeehm ◽

Brigitte van der Heijden

Keyword(s):

Systematic Review ◽

Carpal Tunnel Syndrome ◽

Median Nerve ◽

Carpal Tunnel ◽

Carpal Tunnel Release ◽

Meta Analysis ◽

Surgical Techniques ◽

Open Release ◽

Flap Coverage ◽

Tunnel Syndrome

We performed a systematic review on the success of different surgical techniques for the management of recurrent and persistent carpal tunnel syndrome. Twenty studies met the inclusion criteria and were grouped by the type of revision carpal tunnel release, which were simple open release, open release with flap coverage or open release with implant coverage. Meta-analysis showed no difference, and pooled success proportions were 0.89, 0.89 and 0.85 for simple open carpal tunnel release, additional flap coverage and implant groups, respectively. No added value for coverage of the nerve was seen. Our review indicates that simple carpal tunnel release without additional coverage of the median nerve seems preferable as it is less invasive and without additional donor site morbidity. We found that the included studies were of low quality with moderate risk of bias and did not differentiate between persistent and recurrent carpal tunnel syndrome.

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Gabapentin as an adjuvant therapy to splinting in carpal tunnel syndrome (CTS): a systematic review and meta-analysis of randomized controlled trials

The Egyptian Journal of Neurology Psychiatry and Neurosurgery ◽

10.1186/s41983-020-00237-5 ◽

2020 ◽

Vol 56 (1) ◽

Author(s):

Ahmed M. Ahmed ◽

Osama G. Hassan ◽

Ahmed A. Khalifa

Keyword(s):

Systematic Review ◽

Carpal Tunnel Syndrome ◽

Carpal Tunnel ◽

Randomized Clinical Trials ◽

Meta Analysis ◽

Pinch Strength ◽

Symptom Severity Scale ◽

Significant Difference ◽

Tunnel Syndrome

Abstract Background Carpal tunnel syndrome (CTS) is a common upper limb entrapment neuropathy; severe cases are treated surgically and mild to moderate can be managed conservatively. The purpose of this systematic review and meta-analysis was to define the efficacy of gabapentin as an adjuvant to splinting in the treatment of mild to moderate CTS. Methods A systematic search through 13 databases, randomized clinical trials (RCTs) reporting the use of gabapentin with splinting in CTS were included and analyzed. Results Three RCTs including 170 patients were eligible. There was no significant difference between gabapentin plus splinting and splinting alone in 5 measured parameters: (1) Symptom Severity Scale (SSS) [MD (95% CI) = − 0.76 (− 2.46–0.93), p = 0.378], (2) Functional Status Scale (FSS) [MD (95% CI) = − 0.23 (− 1.40–0.94), p = 0.701], (3) visual analogue scale (VAS) to assess pain [MD (95% CI) = − 0.6 (− 1.47–0.27), p = 0.174], (4) Grip strength [MD (95% CI) = − 0.11 (− 0.70–0.48), p = 0.718], and (5) pinch strength [MD (95% CI) = 0.72 (− 0.10–1.54), p = 0.083]. Conclusion This review provides low-quality evidence that gabapentin plus nocturnal splinting is not superior to splinting alone. More high-quality trials are needed to determine the role of this drug as an adjuvant in the management of CTS.

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