Manipulative treatment of carpal tunnel syndrome

Biomechanical and osteopathic intervention to increase the length of the transverse carpal ligament

Benjamin M. Sucher, Richard N. Hinrichs

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

To quantify the amount of transverse carpal ligament (TCL) elongation in response to osteopathic manipulation or sustained load bearing (or both), a study involving seven cadaver limbs was conducted. Distances from the trapezium to the hamate (distance A) and from the scaphoid to the pisiform (distance B) were measured in five mounted cadaver limbs during and after the limbs bore the weight (2 newtons [N] to 4 N) for 2 several-hour periods. A several-hour period occurred between the weight bearing to assess recoil. Distances A and B were measured before and after the limbs were manipulated, according to previously described techniques, as well as with a new maneuver, termed the 'guy-wire' technique. Two dissected limbs also were subjected to further weight bearing, this time increased to 8 N. Greater weight loads produced greater lengthening of the TCL, and recoil after removal of weight loads was slower than recoil after manipulation. Manipulation was more effective than weight loading for increasing distance A (distal canal), but weight loading generally was more effective than manipulation for increasing distance B (proximal canal). The guy-wire manipulation combined with direct transverse extension appeared to have the greatest impact on lengthening the TCL distally. These results show promise for the effective use of manipulation and load bearing for TCL elongation and nonsurgical relief of pressure on the median nerve in patients with carpal tunnel syndrome.

Original languageEnglish (US)
Pages (from-to)679-686
Number of pages8
JournalJournal of the American Osteopathic Association
Volume98
Issue number12
StatePublished - Dec 1998

Fingerprint

Carpal Tunnel Syndrome
Wrist
Ligaments
Weight-Bearing
Extremities
Weights and Measures
Cadaver
Osteopathic Manipulation
Therapeutics
Median Nerve
Pressure

Keywords

  • Biomechanics
  • Carpal tunnel
  • Manipulation

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Manipulative treatment of carpal tunnel syndrome : Biomechanical and osteopathic intervention to increase the length of the transverse carpal ligament. / Sucher, Benjamin M.; Hinrichs, Richard N.

In: Journal of the American Osteopathic Association, Vol. 98, No. 12, 12.1998, p. 679-686.

Research output: Contribution to journalArticle

@article{372b84d21a454d3dba64871a88b1b9f1,
title = "Manipulative treatment of carpal tunnel syndrome: Biomechanical and osteopathic intervention to increase the length of the transverse carpal ligament",
abstract = "To quantify the amount of transverse carpal ligament (TCL) elongation in response to osteopathic manipulation or sustained load bearing (or both), a study involving seven cadaver limbs was conducted. Distances from the trapezium to the hamate (distance A) and from the scaphoid to the pisiform (distance B) were measured in five mounted cadaver limbs during and after the limbs bore the weight (2 newtons [N] to 4 N) for 2 several-hour periods. A several-hour period occurred between the weight bearing to assess recoil. Distances A and B were measured before and after the limbs were manipulated, according to previously described techniques, as well as with a new maneuver, termed the 'guy-wire' technique. Two dissected limbs also were subjected to further weight bearing, this time increased to 8 N. Greater weight loads produced greater lengthening of the TCL, and recoil after removal of weight loads was slower than recoil after manipulation. Manipulation was more effective than weight loading for increasing distance A (distal canal), but weight loading generally was more effective than manipulation for increasing distance B (proximal canal). The guy-wire manipulation combined with direct transverse extension appeared to have the greatest impact on lengthening the TCL distally. These results show promise for the effective use of manipulation and load bearing for TCL elongation and nonsurgical relief of pressure on the median nerve in patients with carpal tunnel syndrome.",
keywords = "Biomechanics, Carpal tunnel, Manipulation",
author = "Sucher, {Benjamin M.} and Hinrichs, {Richard N.}",
year = "1998",
month = "12",
language = "English (US)",
volume = "98",
pages = "679--686",
journal = "The Journal of the American Osteopathic Association",
issn = "0098-6151",
publisher = "American Osteopathic Association",
number = "12",

}

TY - JOUR

T1 - Manipulative treatment of carpal tunnel syndrome

T2 - Biomechanical and osteopathic intervention to increase the length of the transverse carpal ligament

AU - Sucher, Benjamin M.

AU - Hinrichs, Richard N.

PY - 1998/12

Y1 - 1998/12

N2 - To quantify the amount of transverse carpal ligament (TCL) elongation in response to osteopathic manipulation or sustained load bearing (or both), a study involving seven cadaver limbs was conducted. Distances from the trapezium to the hamate (distance A) and from the scaphoid to the pisiform (distance B) were measured in five mounted cadaver limbs during and after the limbs bore the weight (2 newtons [N] to 4 N) for 2 several-hour periods. A several-hour period occurred between the weight bearing to assess recoil. Distances A and B were measured before and after the limbs were manipulated, according to previously described techniques, as well as with a new maneuver, termed the 'guy-wire' technique. Two dissected limbs also were subjected to further weight bearing, this time increased to 8 N. Greater weight loads produced greater lengthening of the TCL, and recoil after removal of weight loads was slower than recoil after manipulation. Manipulation was more effective than weight loading for increasing distance A (distal canal), but weight loading generally was more effective than manipulation for increasing distance B (proximal canal). The guy-wire manipulation combined with direct transverse extension appeared to have the greatest impact on lengthening the TCL distally. These results show promise for the effective use of manipulation and load bearing for TCL elongation and nonsurgical relief of pressure on the median nerve in patients with carpal tunnel syndrome.

AB - To quantify the amount of transverse carpal ligament (TCL) elongation in response to osteopathic manipulation or sustained load bearing (or both), a study involving seven cadaver limbs was conducted. Distances from the trapezium to the hamate (distance A) and from the scaphoid to the pisiform (distance B) were measured in five mounted cadaver limbs during and after the limbs bore the weight (2 newtons [N] to 4 N) for 2 several-hour periods. A several-hour period occurred between the weight bearing to assess recoil. Distances A and B were measured before and after the limbs were manipulated, according to previously described techniques, as well as with a new maneuver, termed the 'guy-wire' technique. Two dissected limbs also were subjected to further weight bearing, this time increased to 8 N. Greater weight loads produced greater lengthening of the TCL, and recoil after removal of weight loads was slower than recoil after manipulation. Manipulation was more effective than weight loading for increasing distance A (distal canal), but weight loading generally was more effective than manipulation for increasing distance B (proximal canal). The guy-wire manipulation combined with direct transverse extension appeared to have the greatest impact on lengthening the TCL distally. These results show promise for the effective use of manipulation and load bearing for TCL elongation and nonsurgical relief of pressure on the median nerve in patients with carpal tunnel syndrome.

KW - Biomechanics

KW - Carpal tunnel

KW - Manipulation

UR - http://www.scopus.com/inward/record.url?scp=0032436016&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0032436016&partnerID=8YFLogxK

M3 - Article

VL - 98

SP - 679

EP - 686

JO - The Journal of the American Osteopathic Association

JF - The Journal of the American Osteopathic Association

SN - 0098-6151

IS - 12

ER -