Chiropractic manipulation for carpal tunnel syndrome: a systematic review

Abstract

Background Although chiropractic is most commonly used for spinal problems, many chiropractors use manipulations for the treatment of non-spinal conditions. Carpal tunnel syndrome (CTS) has been identified as one such condition. This systematic review evaluates the evidence for or against the effectiveness of chiropractic as a treatment for CTS. Methods Eight electronic databases were searched from inception until November 2008. Reference lists of retrieved articles were hand-searched. Chiropractic associations were contacted in order to identify further non-published studies. No language restrictions were applied. Results Of 26 potentially relevant studies, only one trial of chiropractic for CTS met all the inclusion criteria. The trial was of poor quality and reported no significant differences between the groups on any outcome measure. However, our re-analyses indicated a significant difference in favour of the control treatment (non-steroidal anti-inflammatory drugs [NSAIDs] use). Adverse effects were noted in both groups. Conclusions There is insufficient evidence to suggest that chiropractic is effective for the treatment of CTS. Therapy should continue to focus on the use of NSAIDs, corticosteroid injection, splinting and surgical release of the median nerve. Further research into the utility of chiropractic for CTS is required.