For many orthopedic conditions the debate is often surgery or therapy? The answer will almost always hinge upon who is asked and answering the question. For Carpal Tunnel Syndrome (CTS), the long held standard has been surgery. But is this really the best solution for the problem? The answer is not so simple and generally depends on the severity of the problem.

Common symptoms of CTS including: numbness/tingling in the thumb and pointer finger, reduced pinch/grip and atrophy of the muscle about the thumb. The GOLD standard diagnostic test for this an EMG. An EMG uses little needles (and an electric current) to measure signal time of the median nerve in this case. An issue with this test is in seeking to confirm vs. rule out CTS, is whether the entire median nerve path is tested. This is because the nerve path could be constricted anywhere along the path (from the neck to the hand) and not just the “carpal tunnel”.

Often, those tested will be deemed to have a positive test. BUT the exact location of the compressed nerve may be in question (though the carpal tunnel is often blamed). The point here is, were the other potential issues ruled out or just CTS confirmed?

So you have the CTS diagnosis, now what? This goes back to paragraph one and the severity and length of symptoms. For those with maybe mild or early onset symptoms, therapy is absolutely the best place. Mere bracing (night splints) are good, but more is necessary. Experience and data has shown physical therapy is an effective treatment for those with CTS.

What can be done from a physical therapy standpoint? The biggest piece is patient education. Teaching patients more about the condition and ways to limit progression of the condition. Next, addressing nerve mobility and sensitivity. This is after all a major component in CTS; the restriction on nerve mobility. Yes, improving mobility and sensitivity is possible through hands-on interventions and exercises that can be taught to patients with CTS. There is also working specifically on the tiny bones and soft tissues at the carpal tunnel. Not to mention teaching patients how to strengthen these hand muscles safely.

For those individuals who have been told they have or believe they are suffering with CTS, now is the time to seek treatment. Treatment is MOST EFFECTIVE in the early stages. Once a person reaches the point where muscle atrophy happens, treatment options become much more limited. Again, the night splint recommendation is great, BUT more can and should be done. Don’t you deserve the best possible care available?

If you do, then therapy has been shown to be EQUAL OR MORE effective than surgery for CTS. Again, a big part of this statement hinges on the level of severity of symptoms. If you are dealing with new or maybe just mild symptoms, now is the best time to address them. Waiting or doing nothing will only take you closer to surgery with no guarantee of success.

If you have more questions on how physical therapy can help those with CTS, simply ask your question below or call 717-440-6197 for more information.