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Manual therapy intervention in the treatment of patients with carpal tunnel syndrome: median nerve mobilization versus medical treatment

Abstract

Background

Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy. Median nerve mobilization is a manual therapy intervention used for treating CTS.

Aim

The aim of the present study was to investigate the effectiveness of median nerve mobilization in relieving manifestations of CTS when compared with conventional medical treatment.

Patients and methods

A total of 28 CTS patients were divided into two groups: patients in group I (n = 18) underwent median nerve mobilization, and those in group II (n = 10) underwent conventional medical treatment. Median nerve mobilization consisted of 18 treatments (three/week for 6 weeks). Patients were assessed for hand sensitivity, paresthesia, strength, pain, night awakening, thenar eminence atrophy, and were subjected to Phalen’s test, Tinel’s sign, Boston Carpal Tunnel Questionnaire’s Symptom Severity Scale (BCTQ-SSS) and Functional Status Scale (BCTQ-FSS), and sensory and motor conduction studies for median nerve at baseline and at 6 weeks after treatment.

Results

At baseline versus at 6 weeks, pain, sensation, paresthesia, tingling, Tinel’s signs, and Phalen’s test outcomes were significantly improved in both groups; wrist flexion and extension improved only in group I. The difference between group I and group II after 6 weeks was significant as regards tingling, pain, wrist flexion, and extension. BCTQ-SSS and BCTQ-FSS scores improved after 6 weeks compared with baseline in patients in group I, whereas in group II the improvement was observed in BCTQ-FSS; the difference between the groups was significant. Sensory nerve conduction velocity, sensory distal latency, sensory amplitude, distal motor latency, and motor amplitude were significantly improved after 6 weeks in group I. In addition, there was a change in the grade of CTS, whereas in group II there was improvement only in sensory nerve conduction velocity; the difference between the groups was not significant.

Conclusion

CTS improves after median nerve mobilization, which is better than conventional medical treatment. It provides support for the use of manual therapy in conservative management of CTS with satisfactory results.

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Correspondence to Rasha A. Abdel-Magied MD.

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Mohamed, F.I., Hassan, A.A., Abdel-Magied, R.A. et al. Manual therapy intervention in the treatment of patients with carpal tunnel syndrome: median nerve mobilization versus medical treatment. Egypt Rheumatol Rehabil 43, 27–34 (2016). https://doi.org/10.4103/1110-161X.177424

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Keywords

  • carpal tunnel syndrome
  • manual therapy
  • median nerve mobilization
  • nerve conduction study