The Importance of Physiotherapy in a Conservative Treatment of Carpal Tunnel Syndrome

Purpose. The purpose of the study was to demonstrate the effect of selected physiotherapy methods in patients with a moderate form of carpal tunnel syndrome treated conservatively and to verify whether a one-month structured therapeutic programme leads to a measurable improvement in pain, joint mobility and swelling of the hand. Materials and Methods. An observational study was carried out in a group of 8 adult patients (4 women, 4 men) aged 39–71 years (mean age 56.25 years) with grade 2 carpal tunnel syndrome. Each patient underwent an entry examination comprising history taking, anthropometric measurement of upper-limb circumferences in the area of the forearm, wrist and metacarpal heads, goniometric measurement of the active and passive mobility of the carpometacarpal joint of the thumb in the sagittal and frontal planes using the SFTR method, and pain assessment on a numeric rating scale. The therapeutic programme lasted one month and consisted of 8 sessions of 50 minutes; it included kinesiotherapy, manual therapy, proprioceptive neuromuscular facilitation, stimulation of hand sensitivity, ultrasound applied to the palmar aspect of the carpometacarpal joint of the thumb (3 MHz, 50 Hz, pulse-pause ratio 1:2, intensity 1.0–1.6 W·cm⁻²) and kinesiology taping. Input and output values were compared using the one-tailed paired t-test at a level of significance α = 0.05. Results. The range of motion of the carpometacarpal joint of the thumb increased in both planes, for the active (sagittal plane p = 0.0001917; frontal plane p = 0.000005688) as well as for the passive range of motion (p = 0.00291 and p = 0.00002326). The intensity of pain decreased from a mean value of 4 to 2.625 (p = 0.00006782). The circumferences decreased in the area of the wrist (p = 0.01047) and of the metacarpal heads (p = 0.04749), while the forearm circumference remained unchanged. Conclusions. One month of targeted physiotherapy significantly reduced pain and swelling and improved the mobility of the thumb in patients with a moderate form of carpal tunnel syndrome. Conservative physiotherapeutic management combined with education in the principles of ergonomics can be recommended before considering surgical decompression in patients with a mild and moderate form of the syndrome.