The long-term effect of neurodynamics vs exercise therapy on pain and function in people with carpal tunnel syndrome: a randomized parallel-group clinical trial

Review written by Ian Gatt info

Key Points

  1. Combination of neurodynamics-based therapy (mobilizations and exercise) can be useful to improve pain and function, both short and long-term, for people suffering mild-to-moderate carpal tunnel syndrome.
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BACKGROUND & OBJECTIVE

Carpal tunnel syndrome (CTS) is a commonly diagnosed peripheral neuropathy with associated pain and impact on functional abilities (1). Physiotherapy has demonstrated superior short-term effectiveness over surgery, as well as an equivalent long-term effectiveness (2, 3).

Two main physiotherapy approaches are frequently used to manage CTS – neurodynamics and exercise therapy. Neurodynamics therapy is characterized by using specific manual techniques to change the mechanical characteristics around peripheral nerves. The effect of neurodynamics manual therapy has been found to be inconclusive in multiple systematic reviews (4, 5). This study aimed to help clarify things, by looking at the effect of neurodynamics vs exercise therapy on pain and function in people with carpal tunnel syndrome.

Physiotherapy has demonstrated superior short-term effectiveness over surgery for carpal tunnel syndrome.
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Carpal tunnel syndrome involves the ‘neuro’ aspect of neuromusculoskeletal rehabilitation, and therefore neurodynamics should form part of the management approach.

METHODS

41 participants were analyzed in this study. Inclusion criteria were >18 years of age and a confirmed CTS diagnosis by a physician and a nerve conduction test. Clinical diagnosis was based on the presence of pain and paraesthesia in the

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