Carpal tunnel syndrome results from ischemic compression of the median nerve as it passes under the wrist flexor retinaculum in an osteofibrous canal. If maintained or repeated, this compression modifies the microcirculation in the connective nerve envelopes (epineurium, perineurium, endoneurium), eventually resulting in venous stasis or intrafascicular edema which alters the axonal transport of the median nerve.

This form of compressive neuropathy is extremely widespread, affecting 8% of the global population with a prevalence of 5.8% among women.

Diagnosis is essentially clinical, first involving a questionnaire, followed by an investigation of superficial sensitivities and a positive response to provocative manipulations.

This increase of pressure in the carpal tunnel can be explained by the nature of its anatomy, synovial tissue abnormality, functional overuse of the wrist or hormonal changes (during pregnancy, in postpartum or during the perimenopause) – factors which explain its prevalence among women.

Compression of the nerve, which will lead to an impairment of its movement, can be direct, leading to damage of the myelin sheath or the axon, or indirect, resulting from compression of the nerve’s vascular system. The resulting symptoms are a reduction in nervous conduction, paresthesia and pain around the sensitive area of the median nerve.

How can the symptoms be relieved with Winback?

The approach will be established after carrying out a differential diagnosis (C6-C7 radiculopathy, thoracic outlet syndrome, cervical myelopathy, peripheral neuropathy, functional paresthesia, etc). Winback treatment provides an option for treating symptoms linked to carpal tunnel syndrome and thus to delay surgical treatment for as long as possible

What symptoms Winback can help with, and how:

• Improve microcirculation in the connective nerve envelopes: CET with strong diathermy

• Reduce venous stasis or intrafascicular edema: dynamic CET with mild diathermy on the carpus, and a vascular application higher up using strong diathermy.

• Improve the physiology of the elements making up the osteofibrous tunnel and in particular the retinaculum: RET with strong diathermy then manual work with the RET bracelets.

• Re-establish neural mobilization of the median nerve: option 2.0 with a return plate on the arm positioned next to the median nerve (anterior side) and the RET bracelet around the metacarpals to optimize the neurodynamic treatment.

Winback and carpal tunnel surgery

In severe cases, surgical intervention is inevitable in order to relieve compression of the median nerve, opening the canal at the ligamentous portion.

If the nerve has been compressed for a long time, it is not unusual for hypoesthesia or pain to persist afterwards. In these cases, revascularization of the nerve with Winback treatment in CET mode provides postoperative analgesia by controlling the paresthesia which can result from the release of the compression.

Treatment of the scar using Winback will also be relevant for avoiding scar-related pathologies.