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Revision sistematica de tratamientos fisioterapeuticos con mejor evidencia para el sindrome del tunel carpiano (Systematic review of physiotherapy treatments with better evidence for the carpal tunnel syndrome) [Spanish]
Alvayay CS, Arce A
Revista de la Sociedad Espanola del Dolor 2008;15(7):475-480
systematic review

INTRODUCTION: The carpal tunnel syndrome (CTS) is a pathology which has a high incidence and it basically consist of a neuropathic compression of the median nerve at the wrist level. Initially, this compression is a nerve neuropraxia, but over the time and neglect this pathology evolves to axonotmesis and, in extreme cases, to neurotmesis. The symptoms and signs of this condition are very limiting to the patient. The pain and the parestesias in the dermatomic and myotomic regions of medial nerve will affect the manual performance of this patients decreasing the performance at work and life quality. Finally, the CTS ends in surgery. For these reasons it is necessary to use physiotherapeutic treatment techniques to avoid surgical procedures and abolish this signs and symptoms. OBJECTIVE: The aim of this study was to search and find the physiotherapeutic treatments with the best existing scientific evidence for the carpal tunnel syndrome with the aim of reducing the signs and symptoms as well as avoiding the surgical procedure. MATERIALS AND METHODS: We use the Medline scientific searcher with de PubMed database, later the papers were filtrated with the aim to obtain the best available evidence (according to the Oxford scale) and finally were analyzed according to the PEDro scale to evaluate the works validity. RESULTS: There were included three articles: two randomized trials (with a high score on the PEDro scale) and a systematic review. Only this three papers approved the inclusion and exclusion criteria. CONCLUSIONS: The use of some physiotherapeutic treatments in doses and treatment time described in this review reduce significantly pain, subjective symptoms, distal motor latency, hand grip and finger pinch strength. However the treatment is symptomatic because there are no data indicating that these physiotherapeutic tools reduce the medial nerve compression.

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