American Osteopathic Association

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Pilot Project Finds Potential In Osteopathic Manipulative Treatment for Carpal Tunnel Syndrome

The Journal of the American Osteopathic Association Report Documents Symptom Relief, No Change in Nerve Function

CHICAGO—March 2, 2015—Patients seeking non-surgical relief of carpal tunnel syndrome may want to consider osteopathic manipulative treatment (OMT) as an alternative to splints, steroids and shots.

A pilot study in the March edition of The Journal of the American Osteopathic Association (JAOA) found that patients who received six weekly sessions of OMT for carpal tunnel syndrome reported less pain and better mobility, although researchers did not find physical improvements in nerve function, size or length.

Carpal tunnel syndrome, essentially a pinched nerve in the wrist, is a painful condition that can cause numbness, tingling and loss of strength. Severe cases are treated with surgical decompression, which is proven to provide long-term relief. Patients with mild to moderate symptoms may be prescribed therapeutic ultrasound, wrist splinting, oral corticosteroids or intra-carpal tunnel steroid injections.

The pilot project was conducted by researchers at A.T. Still University-School of Osteopathic Medicine in Arizona working with physicians from Rehab Arizona and the University of Alberta in Edmonton. The researchers used the Boston Carpal Tunnel Syndrome Questionnaire, a sensory symptom diagram, electrophysiologic testing of the median nerve and carpal tunnel ultrasound imaging to assess the nine study participants before and after six weeks of OMT.

The researchers suggested that the patients’ symptom relief may be a function of central nervous system processes and noted that several studies evaluating the effectiveness of non-invasive treatment for mild to moderate carpal tunnel syndrome have also shown significant symptom improvement without evidence of better nerve function.

"While osteopathic manipulative treatment can consistently relieve carpal tunnel syndrome symptoms, the underlying mechanism of the treatment still remains unclear," said investigator Deborah M. Heath, DO, of the A.T. Still University-School of Osteopathic Medicine in Arizona. “We found a persistent tender point on the third rib on the affected side in all patients and included it in the treatments.  Discovering this remote tender point implies that there may be a central nervous system mechanism involved rather than just a local phenomenon."

The full study is accessible until May 1, 2015.

About The Journal of the American Osteopathic Association

The Journal of the American Osteopathic Association (JAOA) is the official scientific publication of the American Osteopathic Association. Edited by Robert Orenstein, DO, it is the premier scholarly peer-reviewed publication of the osteopathic medical profession. The JAOA’s mission is to advance medicine through the publication of peer-reviewed osteopathic research.


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