Myofascial release for carpal tunnel syndrome

All too often, people diagnosed with carpal tunnel syndrome (CTS) have surgery, only to find later that their symptoms have not improved.

by Maria Troia — 

All too often, people diagnosed with carpal tunnel syndrome (CTS) have surgery, only to find later that their symptoms have not improved.

One reason for this is a phenomenon known as pseudo-carpal tunnel syndrome. Another is double crush syndrome. Both are reversible soft tissue imbalances, easily treated with the John Barnes Approach to Myofascial Release (MFR).

When I was in school, my medical massage therapy instructor would say, “He who treats the site of pain is lost.” And so it is with pseudo-CTS and double crush syndrome. Because medical specialists are trained to focus on the area of complaint, they rarely investigate other nonsymptomatic but causative structures, sometimes leading to misdiagnosis and, unfortunately, unnecessary surgeries.

Pseudo-CTS happens when other muscles are tight along the arm, neck or chest on the same side as the symptomatic wrist. A tight pronator teres, a muscle located near the elbow, can affect the median nerve, causing neurological symptoms in the wrist, as can the scalenus, a muscle group found on the front side of the neck, as well as the pectoralis minor, located deep to the pectoralis major in the chest. When tight, any of these muscles can clamp down on the median nerve or the brachial plexus, a nerve bundle that supplies the median nerve.

In the case of double crush syndrome, there may be minimal impingement to the median nerve at the wrist, but sometimes not enough to create symptoms if only that one structure is involved. But add to this imbalance a tight pectoralis minor or scalenus or pronator teres, and that nerve is now crushed in two locations (hence the name double crush), creating enough pressure on the nerve to also create symptoms in the wrist. Take the pressure off of one of these other structures and the wrist is often no longer symptomatic. After a course of MFR therapy, surgery is often not necessary.

A MFR session takes both of these syndromes into account for the client presenting with carpal tunnel syndrome. When MFR therapists assess a client with a wrist complaint, we immediately look further up the line for another possible source of the problem, beyond the site of pain.

Each MFR session is a discovery process. This highly effective, noninvasive and cost-efficient option gets to the root cause of a CTS diagnosis and corrects the dysfunctional pattern in the connective tissue.


Maria Troia, MSEd, LMT, NCTMB, CH is trained in the John Barnes Approach to Myofascial Release and AMMA Therapy®. She is a NCBTMB continuing education provider in Scottsdale, Ariz. 480-313-6260 or

Reprinted from AzNetNews, Volume 29, Number 1, Feb/Mar 2010.

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