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Background:Migraine headache poses a major public health problem. Pharmacological treatment is the most common management strategy, however patients are increasingly seeking alternative treatments. The Watson Headache®Approach (targeted and sustained non-manipulative mobilisation on C0–C3) is used to reduce headache symptoms and provide sustained relief. This research aimed to assess this approach as a treatment strategy for migraine headache and to provide data to inform a subsequent randomised controlled trial.Methods:One-hundred-and-one migraineurs were randomised to either the ‘treat now’ (n=54) or ‘wait list’ (n=47) group. Physiotherapists trained in the approach provided the intervention. Participants received six sessions. Outcome data were collected as a headache diary, including: headache score, headache days, headache duration, pain and medication use. Follow up was immediately post treatment (FU0) and at 3 (FU3), 6 (FU6) and 12 months (FU12).Results:Between-group analysis found no difference between the wait list group at baseline 2 and the treat now group at FU0 for any of the variables of interest. Within-group analysis found that after treatment participants experienced a reduction in headache intensity (P=0.007) and duration (P<0.001), had fewer headache days/28 days (P<0.001), hours of severe migraine headache (P<0.001) and used 20% fewer medications compared with before treatment (P<0.001).Conclusion:The Watson Headache®Approach shows promise as a potential strategy for migraine management, however further work is required to assess the efficacy of this technique in a larger, randomised placebo-controlled trial. Future studies should aim to identify those most likely to benefit from treatment and who may be at risk of potential adverse event.

•Relative motion flexion orthoses can be used after zone I or II flexor repairs.•Data from cohort studies suggest equivalent outcomes to other orthoses.•Relative motion flexion orthoses enable early hand function.•Dorsal-blocking and relative motion orthoses are compared in an ongoing trial.

Carpal tunnel syndrome (CTS) is the most common peripheral nerve entrapment syndrome, and it frequently presents in working-aged adults. Its mild form causes ‘nuisance’ symptoms including dysaesthesia and nocturnal waking. At its most severe, CTS can significantly impair motor function and weaken pinch grip. This review discusses the anatomy of the carpal tunnel and the clinical presentation of the syndrome as well as the classification and diagnosis of the condition. CTS has a profile of well-established risk factors including individual factors and predisposing co-morbidities, which are briefly discussed. There is a growing body of evidence for an association between CTS and various occupational factors, which is also explored. Management of CTS, conservative and surgical, is described. Finally, the issue of safe return to work post carpal tunnel release surgery and the lack of evidence-based guidelines are discussed.