Carpal Tunnel Syndrome

Carpal Tunnel Syndrome Basics

For an overview of carpal tunnel syndrome, please see the carpal tunnel syndrome brochure below. 

Carpal Tunnel Syndrome Information Brochure
Carpal Tunnel Syndr Broch Web Version 12[...]
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Graston Technique and Carpal Tunnel Syndrome

Graston Technique (GT) is an extremely effective form of instrument-assisted soft tissue manipulation used for a variety of acute and chronic musculoskeletal conditions. The GT steel instruments break-up restrictions, adhesions, and scar tissue in the muscles and connective tissue to restore normal tissue tone and mobility.


Carpal tunnel syndrome (CTS) is a condition in which the median nerve becomes compressed by enlargement and irritation of the tendons running through the carpal tunnel. CTS is a condition that develops from chronic overuse of the hands and wrists, typically through activities like typing, data entry, hammering, and other hand use intensive activities.


CTS was previously thought to be an overuse tendinitis, where inflammation in the carpal tunnel caused compression of the median nerve.  While CTS is inflammatory during acute flares of the condition, it has been known for many years that once the condition is subacute or chronic there is very little, if any, inflammation present. Studies have shown that the tendons running through the carpal tunnel become enlarged and weakened, looking much like a frayed rope under a microscope. Enlargement and decreased mobility of the tendons then leads to adhesions in the surrounding connective tissue, further leading to increased immobility throughout.  


Kahn, et al, discussed in detail the pathological changes in overuse tendon disorders like CTS and suggests appropriate clinical treatment approaches.1 Kahn also noted that it would be more appropriate to call these conditions a tendinopathy, rather than tendonitis; since there is little to no inflammation present once the condition is established. (The suffixes “itis” indicating the presence of inflammation and “opathy” meaning pathological changes.)


Given the non-inflammatory tissue changes associated with overuse tendinopathies, manual interventions aimed at breaking up fibrotic adhesions in the connective tissue should be a first line treatment of choice. The orthopedist James Cyriax first introduced cross-fiber friction massage for treatment of these types of conditions and many other therapies have followed since.


Graston Technique is a form of therapy based-on similar concepts to Cyriax's work, but is unique in that the stainless steel instruments are used during treatment to break-up fibrotic, adhesed tissue and initiate a healing cascade. GT has been in use successfully around the country since 1993 for rapid and more complete healing from overuse tendinopathy and a large variety of other soft tissue conditions.


Specifically with carpal tunnel syndrome, GT has very high success rates with relatively short treatment protocols. One study showed that out of 100 carpal tunnel patients undergoing GT treatment, 81 reported good to excellent results with 80-90% improvement or better. Only 5 reported no change in their condition. The patients in the study averaged 8 treatments throughout the study.2   


1 - Khan, KM. Time to abandon the “tendinitis” myth: Painful, overuse tendon conditions have a non-inflammatory pathology. BMJ 2002;324:626-627 ( 16 March )


2 -





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