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Letters to the Editor  |   June 2015
Response
Author Notes
  • Taylor Burnham, OMS III A.T. Still University–School of Osteopathic Medicine in Arizona (Mesa) 
  • Derek Higgins, DO Rehab Arizona, Mesa 
  • Robert Burnham, MD Central Alberta Pain and Rehabilitation Institute in Lacombe; Division of Physical Medicine and Rehabilitation, Department of Medicine, University of Alberta, Edmonton, Canada 
  • Deborah Heath, DO A.T. Still University–School of Osteopathic Medicine in Arizona (Mesa) 
Article Information
Neuromusculoskeletal Disorders / Osteopathic Manipulative Treatment / Professional Issues
Letters to the Editor   |   June 2015
Response
The Journal of the American Osteopathic Association, June 2015, Vol. 115, 357. doi:10.7556/jaoa.2015.084
The Journal of the American Osteopathic Association, June 2015, Vol. 115, 357. doi:10.7556/jaoa.2015.084
We thank Sucher1 for his interest and commentary on our study2 and acknowledge that he has done the majority of the foundational work on this topic. In our study,2 we found that carpal tunnel syndrome symptoms improved substantially after osteopathic manipulative treatment (OMT). However, we recorded no objective evidence of improved median nerve function or morphology at the carpal tunnel, suggesting that the symptom improvement was not likely related to median nerve decompression. 
Sucher1 appropriately reminds us that additional and potentially more effective OMT techniques—including transverse extention and guy-wire manipulative techniques—could be applied to lengthen the transverse carpal ligament and thereby potentially decompress the median nerve. Best practices also include recording tissue response using a quantitative palpatory assessment with the aim of reducing restriction to below a 2/5 level. 
Also, Sucher1 reminds us of the importance of following OMT with a home self-stretching program. These excellent suggestions may augment an already effective treatment. Future research that incorporates these techniques and employs outcome measures using validated subjective measures, as well as objective measures such as those employed in our study, is encouraged. 
References
Sucher BM. Effectiveness of OMT for carpal tunnel syndrome [letter]. J Am Osteopath Assoc. 2015; 115(6): 356-357. doi:10.7556/jaoa.2015.073.
Burnham T, Higgins DC, Burnham RS, Heath DM. Effectiveness of osteopathic manipulative treatment for carpal tunnel syndrome: a pilot project. J Am Osteopath Assoc. 2015; 115(3): 138-148. doi:10.7556/jaoa.2015.027. [CrossRef] [PubMed]