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Chiropractic Research Review

Evaluation and Management of Carpal Tunnel Syndrome

Carpal tunnel syndrome (CTS) may be the most common type of peripheral nerve entrapment seen in clinical practice. Efforts to define factors contributing to this condition have been complicated by a lack of consensus on diagnostic criteria and difficulty in identifying the exact origin of the pain.

This article reviews anatomical, physiological and assessment considerations in the clinical management of CTS.

Evaluation strategies discussed include patient symptomatology, physical and orthopedic examination, and differential diagnoses. Conservative management strategies are outlined (including discussion of conservative medical treatments) and chiropractic management of CTS is presented, including:

* joint manipulation;
* mechanical reflex stimulation;
* taping;
* soft tissue procedures;
* physiotherapy and rehabilitation; and
* potential nutritional considerations.

The authors conclude: "The spectrum of disorders associated with CTS is vast... although standard provocative orthopedic and neurologic tests can be revealing, a thorough mechanical functional approach may be particularly valuable for patients reporting CTS symptoms but with minor or subclinical findings."

Note: Numerous photographs are included within the text, providing a well-rounded presentation of this common condition. The authors note that a variety of mechanical dysfunctions may occur in the forearm and wrist of patients with CTS or wrist pain syndromes, a fact worth clinical consideration.

Barsten G, McCarthy K. Conservative chiropractic approaches to carpal tunnel syndrome. Topics in Clinical Chiropractic, Dec. 1999:6(4), pp62-72. Reprints: (800) 638-8437

Chiropractic Research Review

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