Can carpal mobilization change the dimensions of the carpal tunnel and median nerve?
- RRS Education
The carpal tunnel (CT) is a fibro-osseous structure bound by the scaphoid, trapezium, pisiform and hook of the hamate, and encased ventrally by the flexor retinaculum. The cross-sectional area (CSA) of the tunnel is influenced by the anatomy of the carpal bones and also by flexion and extension of the wrist. Passing through the CT with the flexor tendons, the median nerve is particularly vulnerable to compression, which is known as carpal tunnel syndrome (CTS). CTS is the most common neuropathy of the upper limb, with prevalence ranging between 3-6% of the adult population.
Surgical release has been used to modify the size of the CT, however, it may or may not alter symptoms of CTS! Localized manual therapy may have clinical value, but the mechanism remains unclear. Therefore, the aim of this study was to quantify change in the cross-sectional dimensions and area of the CT and median nerve during manual mobilization of the carpal bones in healthy subjects.
This study is the first to quantify the effects of manual mobilization (transverse force application) on asymptomatic subjects, demonstrating that mobilizations resulted in morphological changes of the CT, specifically increases in CSA of the median nerve and CT. Previous modelling studies have demonstrated similar changes... a simple but very cool study that helps us understand at least part of the mechanism of effect of manual therapy applied to the wrist…LOG IN OR SUBSCRIBE TO ACCESS THIS REVIEW!
THIS WEEK'S RESEARCH REVIEW: “Dimensional Changes of the Carpal Tunnel & Median Nerve During Carpal Mobilization”
This paper was published in Musculoskeletal Science and Practice (2018) and this Review is posted in Recent Reviews, Wrist & Hand and the 2019 Archive.