Wrist & Forearm Injuries
The hands and wrists are involved in nearly every daily activity, from gripping a pen to getting dressed. When hand pain interferes, performing every day activities becomes difficult.
The Touch Research Institute in Miami, FL has done a tremendous amount of work to investigate the physiological effects of massage and manual therapy. Yet, only a few of the studies from the TRI have focused on the effects of massage in addressing orthopedic disorders. This study should help pave the way for further investigations into the effectiveness of massage in treating a number of nerve compression pathologies.
Carpal tunnel syndrome (CTS) is a nerve compression problem that has expanded to epidemic proportions. Due to repetitive occupational activities, and especially the advent of the computer, the incidence of this condition is dramatically increasing. It is characterized by pain, numbness, and/or tingling in the median nerve distribution of the hand. In more severe cases weakness in grip strength may be noticed as motor fibers are affected.
The carpal tunnel is the space in the wrist (actually at the base of the hand) that is bounded by the carpal bones and the transverse carpal ligament. There are nine tendons, including synovial sheaths, and the median nerve that travel through the carpal tunnel. The median nerve is the most superficial structure traveling through the tunnel and is therefore likely to get compressed against the TCL in this condition. Compression of the median nerve in the tunnel will produce the characteristic symptoms of CTS. If the compression is not severe, the person can recover full, pain-free function once the damaged nerve tissue has healed. However, if the compressive forces on the median nerve are not relieved, severe and irreversible damage can occur.
A number of medical interventions are currently used to treat CTS. Wrist splints are one of the most common with the idea being that holding the wrist in a neutral position will allow less compressive force on the median nerve and allow for healing of the nerve to take place. Other commonly used treatment procedures include stretching, non-steroidal anti-inflammatory drugs (NSAIDS), and corticosteroid injections. If these conservative measures are not effective, surgical treatment is performed. Surgical treatment usually consists of a procedure aimed at cutting the transverse carpal ligament in order to decrease its compression of the median nerve.
While a number of these treatment approaches have been studied in the literature, none have proven to be highly effective in treating the problem. Very few alternative treatments have been studied and this is the first clinical study we are aware of that has looked specifically at massage therapy being used for treatment of carpal tunnel syndrome.
In a study published in the “Journal of Bodywork and Movement Therapies” (2004), 16 participants with a confirmed diagnosis of CTS were identified. All of them engaged in work that involved significant time at the computer as well. Following the treatments each participant was asked to assess their condition according to four different criteria: grip strength, pain, anxiety, and depression. Anxiety and pain are often correlated with various pain and injury conditions and that is why they were evaluated in this study.
There were greater improvements in the massage group as compared to the control group in a number of different categories. The massage group showed fewer carpal tunnel symptoms as well as improvement on the nerve conduction test. In addition, improvement was also noted in functional activities, as there was a decrease in pain and an increase in grip strength.
The findings from this study indicate that massage and manual therapy is effective in reducing pain and improving various symptoms of carpal tunnel syndrome. Here at Precision Muscle Recovery, we can apply specialized therapy techniques to decrease the pain associated with CTS.
For more information or to schedule an appointment, please call Precision Muscle Recovery at 480.755.5065.