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ACTIVES RELIEF MANEUVERS IN CARPAL TUNNEL SYNDROME
Author(s) -
Manente G.,
Staniscia T.,
Ragno M.,
Pineto F.,
Romano F.,
Uncini A.
Publication year - 2002
Publication title -
journal of the peripheral nervous system
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1
H-Index - 67
eISSN - 1529-8027
pISSN - 1085-9489
DOI - 10.1046/j.1529-8027.2002.7011_30.x
Subject(s) - carpal tunnel syndrome , medicine , numerical digit , carpal tunnel release , pain relief , surgery , carpal tunnel , physical medicine and rehabilitation , physical therapy , mathematics , arithmetic
In 1999 we described a maneuver, called Carpal Tunnel Syndrome Relief Maneuver (CTS‐RM), which eases or abolishes paresthesias or pain in carpal tunnel syndrome by gently squeezing the distal heads of the metacarpal bones (excluding the first) and stretching the third and fourth fingers. For the same purpose we recently developed two active counter‐resistance maneuvers which we called Carpal Tunnel Actives Relief Maneuvers (CTS‐ARMs). In CTS‐ARM n. 1 the patient uses maximum effort to bring digit I closer to digits IV and V (which should touch), while the examiner offers maximum resistance. On the contrary in CTS‐ARM n. 2, the patient uses maximum effort to distance digit I from digit IV and V (which should touch), while the examiner offers maximum resistance. To verify the efficacy of these maneuvers we enrolled 81 consecutive patients (120 hands) with CTS symptoms and signs and abnormal electrodiagnostic study. At clinical examination 38 patients (47%), 11 men and 27 women, complained of paresthesias in 54 hands (45%). In these patients we performed the three maneuvers: (1) the CTS‐RM; (2) the CTS‐ARM n.1 and (3) CTS‐ARM n. 2. The CTS‐ARMs 1 and 2, were successful in 51 hands (94%). In 40 hands (74%) there was complete abolition and in 11 (20%) improvement of paresthesias in a few seconds. In 3 hands (5.6 %) the CTS‐ARMs did not improve or worsen the paresthesias. The three maneuvers had almost the same results except in the three hands in which the CTS‐RM improved the paresthesias whereas CTS‐ARMs did not. We believe that the CTS‐ARMs may reduce compression and ischemia of the median nerve by stretching and raising the transverse carpal ligament. The CTS‐ARMs may help in clinical diagnosis of CTS, can be useful to relieve symptoms and provide the rationale for therapeutic hand exercises in CTS.