Chiropractic manipulation for carpal tunnel syndrome: a systematic review

Katherine J Hunt, S K Hung, Kate Boddy and Edzard Ernst

Complementary Medicine and PenCLAHRC, Peninsula Medical School, Universities of Exeter and Plymouth, Exeter, UK

Correspondence: Katherine J Hunt, Complementary Medicine, Victoria Park Road, Exeter EX2 4NT, UK. Email: [email protected]

Background. Although chiropractic is most commonly used for spinal problems,many chiropractors use manipulations for the treatment of non-spinalconditions. Carpal tunnel syndrome (CTS) has been identifiedas one such condition. This systematic review evaluates theevidence for or against the effectiveness of chiropractic asa treatment for CTS.

Methods. Eight electronic databases were searched from inception untilNovember 2008. Reference lists of retrieved articles were hand-searched.Chiropractic associations were contacted in order to identifyfurther non-published studies. No language restrictions wereapplied.

Results. Of 26 potentially relevant studies, only one trial of chiropracticfor CTS met all the inclusion criteria. The trial was of poorquality and reported no significant differences between thegroups on any outcome measure. However, our re-analyses indicateda significant difference in favour of the control treatment(non-steroidal anti-inflammatory drugs [NSAIDs] use). Adverseeffects were noted in both groups.

Conclusions. There is insufficient evidence to suggest that chiropracticis effective for the treatment of CTS. Therapy should continueto focus on the use of NSAIDs, corticosteroid injection, splintingand surgical release of the median nerve. Further research intothe utility of chiropractic for CTS is required.

Key Words: Carpal tunnel syndrome • chiropractic • systematic review