Some people develop carpal tunnel syndrome because there is not enough room in the wrist. This article shows that by mobilizing the carpal bones, it increases the cross-sectional area of the tunnel, thereby making room for the nerve. ~ Dr. Broussard
Dimensional changes of the carpal tunnel and the median nerve during manual mobilization of the carpal bones
Musculoskeletal Science and Practice
Volume 36, August 2018, Pages 12-16
Highlights
• Cross-sectional area of the carpal tunnel increased during the manual mobilization of the carpal bones.
• The mobilization increased the anterior-posterior diameter of the carpal tunnel.
• Both the carpal tunnel and the median nerve became rounder during the technique.
• Differences in the median nerve dimensions were considered as irrelevant.
Abstract
Introduction
The carpal tunnel is a clinically important fibro-osseous conduit for the median nerve and associated tendons. It is mechanically dynamic, such that the dimensions of the tunnel and median nerve change with position, movement and application of externally applied force with mechanical devices. Therapeutic manual techniques that appear to move and change tunnel shape are part of clinical practice. The aim of this study was therefore to measure changes in dimensions of the carpal tunnel and median nerve with manual mobilization of the carpal bones.
Material and methods
An analytical descriptive study with 18 volunteer subjects and a total of 33 records was designed. Ultrasound measurements of the cross-sectional area (CSA), anteroposterior diameter (APD), transverse diameter (TD), perimeter, flattening ratio and circularity of the carpal tunnel and of the median nerve, were measured, both in the anatomical position of the wrist and during mobilization techniques of the carpal bones.
Results
During the mobilization technique, the tunnel (p = 0.003) CSA significantly increased. APD also increased significantly for the tunnel (<0.001) while TD decreased. The median nerve showed similar and significant (p < 0.001) changes than the tunnel. However, because several of the obtained differences where smaller than the SDD obtained in a previous study, these differences were considered as irrelevant.
Conclusions
Manual mobilization of the carpal bones produced significant changes in the dimensions of the carpal tunnel.