Self Myofascial Stretching as an Effective Treatment for Carpal Tunnel Syndrome

Carpal tunnel syndrome (CTS) or technically known as median mononeuropathy at the wrist, is the most common nerve entrapment syndrome. It is caused by compression of the median nerve as it crosses the wrist in the carpal tunnel. Various manual therapy treatments have been suggested, e.g., stretching the carpal ligament may decrease the pressure in the carpal tunnel and have been shown to relieve CTS.

Now, a study from Santa Clara Valley Medical Center examined the effectiveness of self-myofascial stretching of the carpal ligament on symptom outcomes and nerve conduction in persons with CTS.

The study was a prospective, double-blinded, randomized, placebo-controlled trial. It recruited 83 participants diagnosed with CTS, and they were randomized either to sham treatment or self-carpal ligament stretching. In the self-treatment group, the participant was instructed to extend his/her wrist at 90 degrees against a wall and hold the near eminence with the contralateral hand as to stretch the carpal ligament. In the placebo group, the participant was instructed to hold his/her hand up perpendicularly and to massage down the dorsal wrist. Participants were asked to perform the self-treatment four times a day for six weeks.

Seventeen participants in the sham treatment group and 19 participants in the carpal ligament stretching group completed the study. The data from the two groups were balanced on age, sex, hand dominance, symptom duration, length of treatment, presence of nocturnal symptoms, and compliance with treatment. The overall statistical analysis did not show a clear benefit; however individual outcome measures demonstrated that the treatment group improved on 5 of 12 criteria while the sham group only improved on 1 of the 12 criteria. The treatment group showed improvement in numbness, tingling, pinch strength, sensory amplitude, and symptom severity scale.

The authors concluded that the self-stretching of the carpal ligament showed statistically significant symptom improvement in persons with CTS.

Shem, Kazuko, Joseph Wong, and Benjamin Dirlikov. “Effective self-stretching of carpal ligament for the treatment of carpal tunnel syndrome: A double-blinded randomized controlled study.” Journal of Hand Therapy (2020).