Researchers found that physical therapy — particularly so-called manual therapy — improved hand and wrist function and reduced pain as effectively as a standard operation for the condition.
Moreover, after one month, physical therapy patients reported better results than those who underwent surgery.
“We believe that physical therapy should be the first therapeutic option for almost all patients with this condition,” said lead study author Cesar Fernandez de las Penas.
“If conservative treatment fails, then surgery would be the next option,” said de las Penas, a professor of physical therapy at King Juan Carlos University in Alcorcon, Spain.
Also, one extra benefit of therapy over surgery may be cost savings, he noted.
Carpal tunnel syndrome occurs when the median nerve, which runs from the forearm into the palm of the hand, becomes squeezed at the wrist. It often arises from repetitive motions required for work, such as computer use or assembly line work.
Symptoms usually start gradually, with patients noticing numbness and weakness in the hand and wrist.
Surgery for the condition generally involves cutting a ligament around the wrist to reduce pressure on the median nerve, according to the U.S. National Institutes of Health.
For this study, de las Penas and his colleagues followed 100 women from Madrid who had carpal tunnel syndrome. Half were treated with physical therapy and half underwent surgery.
For three weeks, the therapy patients received weekly half-hour manual therapy sessions — meaning therapists only used their hands. The therapists focused on the neck and the median nerve. They also applied manual physical therapy to the shoulder, elbow, forearm, wrist and fingers. On their own, patients performed neck-stretching exercises at home.
After one month, the therapy group reported greater daily function and greater “pinch strength” between the thumb and forefinger compared to the surgery patients. After three, six and 12 months, however, improvements were similar in both groups. All participants experienced similar reductions in pain.