Treatment guidelines for carpal tunnel syndrome (CTS) encourage patients to utilize non-surgical options before consulting with a surgeon, of which chiropractic care is an excellent choice. To manage the patient with carpal tunnel syndrome, a doctor of chiropractic will take a multimodal approach—that is, they will combine several therapies in order to achieve an optimal treatment outcome. One tool that may be incorporated into care is mechanical wrist traction.
In simple terms, mechanical wrist traction is a process by which a device is utilized to pull the hand away from the arm to elongate the tissues between, namely those in the carpal tunnel. It’s believed this reduces pressure in the wrist and facilitates nerve mobility.
In a 2017 study that included 181 CTS patients, participants received either 12 treatments of mechanical wrist traction twice a week for six weeks or usual medical care. The protocol for mechanical traction involved using weights that range from 1-18 kg on the affected hand for ten to fifteen minutes per session, depending on the patient’s comfort level. Patients in the care-as-usual group received a combination of wrist splinting and local corticosteroid injection.
The researchers monitored the patients’ progress for six months and found that 43% of the usual care group progressed to surgery compared with just 28% of the traction group. A follow-up study published in 2021 found that participants in the traction group continued to be less likely to require surgical intervention (44% vs 37%). Additionally, patients in the traction group were about 2.5 times less likely to drop out, suggesting they were more satisfied with their care than those in the usual care group. The authors concluded that mechanical traction is an effective non-surgical, conservative treatment option for the CTS patient.
In addition to conservative treatment to improve nerve mobility and reduce inflammation in the wrist, doctors of chiropractic will also examine the full course of the median nerve as it travels from the neck to the hand. This serves two purposes: 1) symptoms like numbness, tingling, pain, and weakness in the hand can also result from dysfunction in the neck, shoulder, elbow, and forearm; 2) CTS can co-occur with other conditions that affect the function of the median nerve, and treatment to resolve both issues may be necessary to achieve a satisfactory result.