Carpal Tunnel Syndrome: Surgery or Skilled Physical Therapy

Carpal tunnel syndrome (CTS) occurs when the median nerve in your wrist becomes compressed as it courses through the carpal tunnel at the base of your hand.  The result of this compression may present as pain or numbness in the hand, wrist or forearm as well as grip weakness.

In a recent article in the March 2017 issue of Journal of Orthopedic and Sports Physical Therapy (JOSPT), researchers found that manual therapy combined with traditional stretching exercises provided similar improvements in hand function and grip strength compared to those who received carpel tunnel surgery.

This study compared a sample size of 100 women, 50 who had surgery for carpal tunnel and 50 who only had skilled physical therapy and no surgery.  The group who received skilled physical therapy received 30 minutes of manual therapy (joint mobilizations, soft tissue mobilization and median nerve glides).  In addition, this group were given stretches as part of a home exercise program

The research showed that after 1 month, patients who received physical therapy had better pinch strength and hand function than patients who had surgery.   At the 3, 6 and 12 month mark, patients had similar improvements regarding hand function and grip strength.   Although both groups showed similar results in the long term, the evidence suggests that skilled manual therapy in conjunction with stretching exercises can provide similar results to invasive (and at times, ineffective) surgery.

The study showed the positive benefits of manual therapy in conjunction with typical physical therapy interventions.  The key, however, is finding a physical therapy provider who not only is proficient in manual skilled physical therapy but also provides the amount of time (30 plus minutes of manual care) needed to achieve positive gains.   Here at Mana Physical Therapy, we provide all of our patients with true one-on-one care our patients to gain the most benefit out of their valuable time.


Journal of Orthopedic & Sports Physical Therapy. Carpal Tunnel Syndrome Physical Therapy or Surgery? JOSPT Perspectives for Patients.  Published March 2017.   Accessed March 31, 2017

Fernandez-de-las Penas et al.  The Effectiveness of Manual Therapy versus Surgery on Self-reported Function, Cervical Range of Motion and Pinch Grip Force in Carpal Tunnel Syndrome:  A Randomized Clinical Trial.  JOSPT 2017; 47 (3): 151-161