End Your Carpal Tunnel Pain Without Surgery is a well written (and optimistic) book about the prevention and recovery of repetitive strain injuries (or work-related musculoskeletal disorders) through a 15-minute daily program. The author, Kate Montgomery, is a Certified Sports Massage Therapist. She also calls herself a Holistic Health Practitioner and Naturopathic Doctor. She has developed “The Montgomery Method” – a twelve-step method for relieving the pain of repetitive strain injuries.

According to Ms. Montgomery, recovery from repetitive injuries requires a four-pronged approach.

• A safe working environment with the proper ergonomic equipment.
  
• A body-maintenance program of chiropractic or osteopathy, therapeutic muscle therapy, and acupressure or acupuncture.
  
• A daily self-care program including a stretching and strengthening program.
  
• A proactive approach towards insurance carriers requesting payment for alternative therapies.

Ms. Montgomery believes that surgery is not the answer to carpal tunnel syndrome in 99 percent of cases. She reports that the failure rate of surgery is very high and that many people who have tried surgery are still not fully functional or able to return to their jobs.

DEALING WITH THE PAIN OF CARPAL TUNNEL (AND OTHER REPETITIVE STRAIN INJURIES)

The Montgomery Method of dealing with pain includes:

• Performing the twelve-step program (outlined below).
  
• Using pain relief techniques such as acupressure to speed healing.
  
• Following a stretching routine.
  
• Once healed, performing a regular strengthening routine.
  
• Warming up regularly.
  
• Working at an ergonomically correct work station.

Ms. Montgomery is quick to point out throughout the book that her methods do not cure carpal tunnel syndrome or any other upper body syndrome. “There is no cure for musculoskeletal injuries – only body maintenance. It is your responsibility to take charge and become an active participant in healing your body.” Rather “The Montgomery Method" is a “preventative and self-care program that all individuals can incorporate into their daily life”. Ms. Montgomery states that her methods bring the body’s structure and muscles back into balance. This improvement in muscular balance will then alleviate pain.

THE TWELVE-STEP PROGRAM

The twelve-step Montgomery Method is a “program of self-correction to align your joints and restore energy and strength to the muscles. This program is designed to help you regain mobility and to support and stabilize the muscles and joints of the arm, wrist and hand.”

• Step 1 – Posture Correction
  
• Step 2 – Perceived Grip Strength Assessment
  
• Step 3 – Neck Massage
  
• Step 4 – Forward Arm Extension
  
• Step 5 – Lateral Arm Extension
  
• Step 6 – Wrist Press
  
• Step 7 – Wrist Pull
  
• Step 8 – Wrist Squeeze
  
• Step 9 – Finger Pull
  
• Step 10 – Upper Back Stretch
  
• Step 11 – Shoulder, Chest and Elbow Stretch
  
• Step 12 – Muscle Therapy
  
  • Trigger Point Release - eliminates trigger points and muscle spasms that cause pain
    
  • Neurolymphatic Massage - speeds muscle healing, flushes the immune system, decreases pain, and regains muscle strength
    
  • Massage Therapy – heals muscle tissue

The last chapter is a concise summary (through pictures) of the twelve-step program, the muscle therapy massage techniques, and the stretching and strengthening exercises.

MY REVIEW OF THE FIRST EDITION

The book End Your Carpal Tunnel Pain Without Surgery is filled with good illustrations of exercises and stretches and charts to help you perform self-acupressure points, self- trigger-point release therapy, and self-massage strokes. Ms. Montgomery writes in clear, non-medical, and easily understood language. Her stretching and strengthening programs provide general and basic exercises for the upper body. She also provides a chapter on basic office ergonomic information.

However, the quoted percentage of those who do not need surgery seems inflated. Although I understand Ms. Montgomery’s frustration that surgery is often considered medically to be a primary solution and not a last line of defense, I have certainly worked with successful releases during my career as a hand therapist. And even though I am considered to be a hand therapist and an occupational therapist, I approach the recovery of repetitive strain injuries in a holistic manner as well - looking at muscular balance, postural issues, work methods and work environment issues, ergonomics, breathing patterns and core strength weakness in addition to the symptoms in the hand. Ms. Montgomery’s four-pronged approach to recovery is not unique to her method. Her approaches are commonly used by any experienced therapist who is looking to treat the cause and not the symptom. I am concerned that Ms. Montgomery does not give enough credit to any but alternative medicine professionals.

For those looking for a self-help guide on relieving upper body pain from repetitive injuries, carpal tunnel and tendonitis, End Your Carpal Tunnel Pain Without Surgery is a holistic guide that is consistent with and complementary to my views on repetitive strain injury recovery and prevention. The exercises provided are basic and general, but the illustrations and the information provided, especially in the section on muscle therapy, are well worth the cost. These methods are tried and true, will certainly not hurt if performed correctly, and will hopefully help you to be the one who recovers without needing surgery.

Purchase End Your Carpal Tunnel Pain Without Surgery (3rd edition) at Amazon.com.

For those interested in following an exercise program on DVD based on the stretching and strengthening exercises that help restore muscular and postural balance, please visit my website.

Hand Health Resources - Healthy Hands on DVD

Marji Hajic is an Occupational Therapist and a Certified Hand Therapist practicing in Santa Barbara, California. For more information on hand and upper extremity injuries, prevention and recovery, visit Hand Health Resources.