Research Articles – Elbow/Wrist

Hands-on therapy reduces pain and has several other positive effects
for patients with carpal tunnel syndrome

Carpal tunnel syndrome is a condition that results from pressure being placed on a nerve in the wrist, which leads to numbness, weakness, tingling and other symptoms in the hand. Carpal tunnel syndrome affects up to 3.8% of the population, and its symptoms often make it difficult for working individuals to complete their jobs. Effective treatment is therefore needed to address carpal tunnel syndrome, and one available option is manual therapy, a physical therapy intervention in which the therapist performs various manipulations with their hands. Due to the fact that evidence is lacking to support these treatments, a powerful study called a randomized-controlled trial was conducted. Results showed that both physical and manual therapy helped patients experience less pain, greater function and fewer symptoms. Patients in the manual therapy group, however, reported average pain reductions of 290% compared to only 47% in the physical therapy group. These findings support the use of manual therapy for carpal tunnel syndrome, and patients with this condition should therefore seek out the services of a physical therapist to receive this type of treatment and any other appropriate interventions.

Supervised physical therapy is found to be more effective
than a home exercise program for treating wrist fractures

A distal radius fracture is the technical term for a broken wrist, which is one of the most common of all injuries. These types of injuries account for between 15-20% of all fractures, and they are especially common in older adults over 60 years of age. Treatment for distal radius fractures typically consists of realigning the broken bone and then putting the patient in a wrist cast. Unfortunately, more than 50% of patients continue to have problems with their wrist after this procedure, and physical therapy is commonly recommended after the cast is removed for this reason. Physical therapy can be administered either at a physical therapy clinic or with a home-exercise program, and it’s not completely clear which of the two is more effective. Therefore, a powerful study called a randomized-controlled trial (RCT) was conducted to compare a supervised physical therapy program to a home-exercise program. Results showed that patients in both groups improved in all of the measurements taken, but the participants who followed supervised physical therapy experienced less pain and better wrist function and flexibility than those who followed a home-exercise program. Even more impressively, these improvements lasted for at least six months. Patients with a broken wrist are therefore encouraged to consider seeing a physical therapist for an effective treatment program after their cast is removed.

Surgery and hands-on therapy lead to similar long-term outcomes
for patients with carpal tunnel syndrome

Carpal tunnel syndrome (CTS) is a painful condition that affects the hands and is particularly common in the workplace, as it accounts for nearly 50% of all work-related injuries. CTS results from a pinched nerve in the wrist, which leads to numbness, tingling and weakness in the affected hand. Conservative (non-surgical) treatment is typically recommended at first for CTS, but if symptoms are severe or the patient doesn’t improve, surgery may be advised. Physical therapy is a common conservative treatment for CTS and may consist of manual therapy, in which the therapist performs various mobilizations and manipulations with their hands. Studies comparing the benefits of surgery and manual therapy have produced mixed results, and it’s not completely clear which is better for patients. For this reason, a powerful study called a randomized-controlled trial was conducted to determine if manual therapy or surgery was more effective for treating patients with CTS. Results showed that after one month, patients in the manual therapy group experienced significantly greater improvements than those in the surgery group. After six and 12 months, the two groups reported more similar scores, but these findings are still supportive of manual therapy. This is mainly due to the fact that manual therapy is significantly less expensive and comes with far fewer risks than surgery, which makes it the much more attractive option of the two.

Aggressive physical therapy immediately
after surgery is effective for broken wrists

Fractures of the distal radius—the larger of the two bones in the forearm—are very common and usually occur from falling on an outstretched arm. If the fracture is severe enough, surgery may be recommended, which is then followed by rehabilitation. The wrist is usually immobilized for several weeks during this process, but some say this period of waiting is not necessary. For this reason, a study was conducted that compared standard rehab with a more accelerated program, and the results showed that patients who started wrist motion earlier actually reported better mobility and strength than the others. Surgeons are usually extra careful about moving patients’ wrists within the first week after surgery, but this study shows it may be safe and lead to better overall outcomes for those who break their wrist.

Physical therapy with exercises that use a rubber
bar effective for treating golfer’s elbow

Medial epicondylitis, or golfer’s elbow, is a painful condition that results from a golf swing or any other similar activity that aggravates the forearm muscles. Physical therapy is often recommended as an effective treatment for golfer’s elbow, and one of its components is eccentric exercises, which can be seen as the opposite motion of conventional exercises. These exercises have been proven effective for a number of other conditions, but research has not yet supported them for golfer’s elbow, which spurred the need for a study. Results from the study showed that patients improved significantly and experienced a decrease in disability as a result of eccentric exercises, which can be integrated into a rehab program for anyone with this condition.

Vitamin C considered effective in reducing
CRPS associated with distal radius fractures

Vitamin C, a water-soluble compound that’s found in a wide array of fruits and vegetables, is essential for a number of important bodily functions and is recommended to improve general health. Some physicians also prescribe vitamin C to patients who’ve recently suffered a wrist fracture to prevent a condition known as complex regional pain syndrome (CRPS), but debate exists as to whether or not it’s effective in doing so. To evaluate vitamin C’s specific role in preventing CRPS, two randomized control trials were analyzed.

Wrist guards’ impact on wrist and elbow injury in snowboarders

An Australian study investigated the effect of wrist guards on both wrist and elbow injuries, as it has been suggested by some that wrist guards can actually lead to elbow injury as a result of redistributing the impact of the force. The study found the claim to be false and the guards to be extremely effective for their purpose.