Carpal tunnel syndrome (CTS) is often associated with hormonal changes like hypothyroidism, pregnancy, or birth control use, as well as metabolic or inflammatory conditions such as type 2 diabetes, rheumatoid arthritis, psoriatic arthritis, or gout. However, in many cases, hand and wrist symptoms result from musculoskeletal problems that compress the median nerve or restrict its movement. Chiropractic care is considered a suitable treatment option for patients with CTS, but an important question remains: how much treatment is typically needed before specific symptoms like numbness, tingling, weakness, or pain begin to improve?
A clinical study involving 22 individuals with CTS—of whom 19 had the condition in both hands and wrists—demonstrated notable results. The participants received only manual therapy targeting the hand, wrist, and forearm three times per week over a two-week period. The outcomes showed significant improvements in pain, functionality, numbness, sensation, hand strength, and reductions in night-time awakenings. Additionally, patients performed better on Phalen’s maneuver, which is a clinical test used to elicit CTS symptoms. Importantly, these improvements were sustained for up to twelve weeks after the final treatment session.
Beyond manual therapies, chiropractors frequently incorporate additional non-surgical methods, including night-time wrist splinting, prescribed exercises and stretches for home use, nutritional advice, and recommendations for job or ergonomic changes. It is also important to consider potential dysfunction in other regions along the median nerve pathway, such as the neck, shoulder, elbow, and forearm, which may require attention during treatment.
If CTS appears to have underlying non-musculoskeletal causes, it may be necessary to coordinate care with the patient’s primary medical provider. Research indicates that, over the long term, surgical treatment for CTS does not consistently outperform non-surgical options, yet surgical referral might be considered if conservative approaches do not achieve satisfactory results.
For most CTS and similar musculoskeletal concerns, chiropractors typically start with a brief care plan—such as six visits over two weeks, mirroring the study protocol—to monitor patient response and adjust the treatment plan accordingly. Patients with mild cases may be discharged from regular care and advised to return as needed. For those with chronic or severe CTS, further treatment may be required. However, if the syndrome has progressed significantly, complete symptom resolution may not be feasible. Early consultation with a chiropractor for hand and wrist complaints is therefore important in optimizing potential outcomes.
