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What Is The Prognosis For Carpel Tunnel Syndrome Which Has Not Improved Despite 6 Weeks Of Physical Therapy?
Question: I just finished physical therapy (therapist through our local hospital) for carpal tunnel syndrome which I've had for a few years..The session was for 6 weeks and it only a little..I think it was a deep tissue therapy though they didn't call it that...(My daughter had the deep tissue therapy when it was just being started by some doctor/therapist !? that she discovered by researching, but she had to travel to Vermont for the therapy for a couple of years...It did work on her though...That therapist has since retired....I feel that therapy could help me though the 6 sessions did not help enough...I do not want surgery..What do you suggest?
Brief Answer:
If no improvement after 6 weeks chances are slim
Detailed Answer:
I read your question carefully and I understand your concern.
Physical therapy is commonly used for carpal tunnel syndrome. Unfortunately, only a minority of patients experience benefits, in many, it isn't enough. I still recommend it though as it is after all the safest alternative.
However, if you have had it for 6 weeks with no major improvement I am afraid the chances are minor, 3-4 more weeks might be added but it is not likely to bring any significant benefits.
Among other options to be mentioned, there are some studies showing benefit with therapeutic ultrasound or local injections of corticosteroids or progesterone.
Oral medication with Gabapentin or Pregabalin is also commonly tried.
However, all these options are of benefit only in a portion of patients, in many surgeries is the only option. I don't know the details of your case (nerve conduction studies degree of damage, evidence of compression), but when there is a clear compression with marked changes on nerve conduction studies I recommend surgery. It is a very simple procedure, with local anesthesia and can be home on the same day. If a mild or moderate case though you may try the other options I mentioned before.
I remain at your disposal for other questions.
If no improvement after 6 weeks chances are slim
Detailed Answer:
I read your question carefully and I understand your concern.
Physical therapy is commonly used for carpal tunnel syndrome. Unfortunately, only a minority of patients experience benefits, in many, it isn't enough. I still recommend it though as it is after all the safest alternative.
However, if you have had it for 6 weeks with no major improvement I am afraid the chances are minor, 3-4 more weeks might be added but it is not likely to bring any significant benefits.
Among other options to be mentioned, there are some studies showing benefit with therapeutic ultrasound or local injections of corticosteroids or progesterone.
Oral medication with Gabapentin or Pregabalin is also commonly tried.
However, all these options are of benefit only in a portion of patients, in many surgeries is the only option. I don't know the details of your case (nerve conduction studies degree of damage, evidence of compression), but when there is a clear compression with marked changes on nerve conduction studies I recommend surgery. It is a very simple procedure, with local anesthesia and can be home on the same day. If a mild or moderate case though you may try the other options I mentioned before.
I remain at your disposal for other questions.
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Answered by
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