Osteopathic Research Web

Does Osteopathic Treatment Have an Effect on the Size of the Median Nerve within the Carpal Tunnel? Assessed Under Ultrasound.

Item

Title

Does Osteopathic Treatment Have an Effect on the Size of the Median Nerve within the Carpal Tunnel? Assessed Under Ultrasound.

Author(s)

Zalewska-Pittman, N

Abstract

Background: Carpal tunnel syndrome (CTS) is one of the most common entrapment neuropathies (Yi-Ho et al 2010) causing pain in the first to the medial side of the fourth digit on the volar surface of the hand. Imaging studies have been carried out in order to determine the clinical features of CTS. Ultrasound has been shown to be effective in determining the severity of CTS and indicate potential intratunnel causes of the symptoms. It has been found that the cross sectional area (CSA) of the median nerve increases when pressure in the carpal tunnel rises, resulting in symptoms of parasthesia, pain and decreased grip strength.The conservative management of CTS has been well documented but the use of Osteopathic medicine has been under researched. The purpose of this study was to establish whether the median nerve cross sectional area could be affected by Osteopathic treatment in asymptomatic subjects. Objectives: To determine whether Osteopathic treatment of healthy subjects affects the median nerve cross sectional area (CSA) in the carpal tunnel using ultrasound imaging. Design: Single measure design experiment using a treatment group and a control group. Methods: 12 participants were recruited from the current 4th year cohort at the European School of Osteopathy: 6 male 6 female with a mean BMI of 23.7 and a mean age of 23 years. Inclusion criteria: Year 4 ESO students without carpal tunnel syndrome between the ages of 18 and 60 years old, negative Phalen's, reverse Phalen's, Tinnels tap tests. Exclusion criteria: Smokers, Under 18, pregnant, diabetic, RA, previous wrist surgery, long term medication, hand/wrist/finger pain, and variations within the carpal tunnel including immobile median nerve and space occupying lesions, which would be assessed under ultrasound. Outcomes: CSA measurements pre and post intervention (Osteopathic treatment) on the dominant hand versus the control group. CSA measurements pre and post intervention on the dominant hand vs the non-dominant hand. Results: Statistically there is no significance between the intervention on the dominant hand versus control (p value 0.5770) , and the non-dominant hand versus control (p values 0.0778). Discussion: Although Osteopathic treatment can influence the GSA of the median nerve within the carpal tunnel, due to the nature of the research question it is not statistically significant. Both increase and decrease could be explained by Osteopathy influencing the autonomic system by increasing parasympathetic activity, Osteopathy aids venous return and arterial supply resulting in the dispersion of interstitial congestion. Osteopathy also directly breaks down adhesions and addressed biomechanical discrepancies which arise from somatic dysfunctions that could lead to impingement of structures. Conclusion: There were increases and decreases in GSA values among participants so statistical analyses of increase versus decrease could be a more accurate reflection of changes. Osteopathic treatment is a viable inclusion to conservative management of CTS. Due to its effect on the parasympathetic nervous system and direct techniques, Osteopathy can reduce congested areas and address restrictions and somatic dysfunctions which alter the normal biomechanics of the upper extremity. By monitoring the GSA under ultrasound the severity of CTS can be established and management can remain conservative.

presented at

European School of Osteopathy

Date Accepted

2015

Date Submitted

2.12.2016 16:55:00

Type

osteo_thesis

Language

English

Submitted by:

62

Pub-Identifier

15929

Inst-Identifier

1229

Keywords

Carpal tunnel syndrome, Osteopathy, Manipulation, Ultrasound

Recommended

0

Item sets

Thesis

Zalewska-Pittman, N, “Does Osteopathic Treatment Have an Effect on the Size of the Median Nerve within the Carpal Tunnel? Assessed Under Ultrasound.”, Osteopathic Research Web, accessed April 23, 2025, https://library.wso.at/s/orw/item/552