Value of soft tissue mobilization versus medical therapy in carpal tunnel syndrome treatment

Document Type : Original Article

Authors

1 Rheumatology, Rehabilitation and physical medicine, Minia University. Minia, Egypt

2 Rheumatology, Rehabilitation and physical medicine department, Minia University. Minia, Egypt

3 Rheumatology, Rehabilitation and physical Medicine, Minia University. Minia, Egypt

Abstract

Objectives: detect effectiveness of soft tissue mobilization (STM) in reliving manifestations, improving function and electrophysiological studies of carpal tunnel syndrome (CTS) compared to medical treatment. This single-blind randomized-control study included sixty CTS-patients; 40 treated by STM and 20 received medical treatment only. STM was applied three-times weekly for six weeks (total of 18-treatments). Patients were assessed clinically, functionally using Boston-Carpal-Tunnel-Questionnaire (SSS (Symptom-Severity-Scale) and FSS (Functional-Status-Scale)) and electrophysiologically for the median nerve. Assessment was done at the base-line and at the end of treatment.
Results: Difference was significantly detected within groups and between both groups treated with STM and medically at the end of treatment regarding tingling, extension&flexion of wrist joint (p≤0.0001), Tinel sign (p=0.001), paresthesia&phalen test (p=0.01), night-awakening and pain (p=0.04). Significant difference within patients treated by STM with respect to SSS and FSS score and grade (p≤0.0001), similar findings couldn't be detected with medical treatment. SSS score and grade showed significant difference between patients in both groups (p≤0.0001) and FSS score and grade (p=0.001,p=0.004). Significant difference within patients treated by STM regarding electrophysiological studies; sensory-amplitude, distal-latency and conduction velocity (p≤0.0001), the motor-amplitude and distal-latency (p=0.008,p=0.004) and changing CTS grade (p=0.01). Patients received medical treatment showed significant difference only in sensory amplitude (p=0.04). Significant difference between both groups regarding changing CTS grade (p=0.03).
Conclusion: Clinical, functional and electrophysiological changes in post-STM treated CTS patients have been detected better than medical therapy alone; thereby offering a satisfactory evidence to justify the usage of manual therapy as a conservative treatment of CTS.

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