The Effect of Neurodynamic Mobilization on Carpal Tunnel Syndrome
Carpal tunnel syndrome (CTS) is one of the most common neuropathy disorders, affecting 3-6% of adults. Carpal tunnel syndrome occurs when the median nerve, which controls the sensory and motor functions of the thumb and majority of fingers, is compressed within the carpal tunnel, an opening in the bone at the wrist. This leads to numbness, tingling, pain, and weakened grip strength in the fingers of the affected hand. CTS is commonly treated with splinting, steroids, anti-inflammatories, or surgery in extreme cases. In less extreme cases, physical therapy and exercise is often recommended to alleviate symptoms of carpal tunnel. One particular set of physiotherapy techniques called neurodynamic mobilization techniques (NMTs) has not been widely studied in relation to carpal tunnel syndrome. NMTs are meant to move nerves within the body, so, in this case, moving the median nerve within the arm and wrist is suggested to relieve the pressure of the carpal tunnel. However, this is not recommended to be done at home and should be done in physical therapy sessions.
NMTs physically manipulate the body to shift nerves into more optimal positions.
Image Source: backy3723
A recent study examining those suffering from carpal tunnel suggested that NMTs could be used to relieve pain associated with carpal tunnel syndrome. The researchers treated 62 female subjects with mild to moderate carpal tunnel syndrome with 20 sessions of physiotherapy during a 10-week period. Each patient was randomly assigned NMT treatment on one arm, and a placebo exercise on the other. The specific NMT exercise used is called “two-ended sliders,” where the median nerve is slid between the wrist and elbow. This involves specific positioning of the arm and precise flexing of the wrists and elbows. Four sets of 30 repetitions were used per session. The results of this experiment showed that, while both the test and control groups showed improvement after treatment, the wrists treated with NMTs had significantly more improvement in grip strength, pain intensity, and function. Grip strength increased by 0.64 kilograms when wrists were treated with NMT while the control increased by 0.54 kilograms. Wrist function, as defined by the BCTQ-FSS questionnaire, improved by 1.37 on a five point scale when treated by NMT while the placebo treatment increased function by merely 0.37. Most importantly, pain intensity, rated out of 10 possible points on the NPRS scale, was rated 1.15 points lower in the NMT wrists than in the placebo group.
Overall, this study indicates the NMTs are a promising field of physiotherapy that could provide relief to those suffering from carpal tunnel that are unable to undergo more invasive treatments. Future research into similar non surgical, physical therapy related treatments for neuropathy issues could provide a wider array of options for patients unable to undergo more extreme medical interventions.
Overall, this study indicates the NMTs are a promising field of physiotherapy that could provide relief to those suffering from carpal tunnel that are unable to undergo more invasive treatments. Future research into similar non surgical, physical therapy related treatments for neuropathy issues could provide a wider array of options for patients unable to undergo more extreme medical interventions.
Featured Image Source: Anete Lusina
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