So you think you need . . . Surgery for carpal tunnel syndrome:Try osteopathy first

Osteopathy is highly successful in treating carpal tunnel syndrome (CTS), especially using what they call the ‘opponens roll’ manoeuvre. In a small study to assess the effectiveness of this procedure together with self-stretching exercises, it was found that hand movement was less restricted and nerve conduction improved in all 16 patients (J Am Osteopath Assoc, 1994; 94: 632, 640).

Myofascial release techniques (which involves specific exercises and self-massage) in addition to self-stretching can also improve the diameter of the carpal tunnel (thereby reducing pressure on the median nerve) and increase the ‘loudness’ of nerve signals (J Am Osteopath Assoc, 1994; 94: 289).

Osteopathy can also help those in whom CTS is a symptom of thoracic outlet, or ‘double crush’, syndrome (J Am Osteopath Assoc, 1995; 95: 471-9). In this syndrome, the nerves and blood vessels supplying the arm become trapped and compressed in the thoracic outlet (which lies just behind the collar bones) at two points, blocking nerve signals. In a case of CTS, the first point of compression in the wrist may be accompanied by compression in the cervical (neck) vertebrae (J Hand Surg, 1985; 10: 202). Osteopathic manipulation and stretching can ease the nerve compression in both the thoracic outlet area and in the neck.