An investigation to compare the effectiveness of carpal bone mobilisation and neurodynamic mobilisation as methods of treatment for carpal tunnel syndrome.

Carpal tunnel syndrome is the most common peripheral entrapment neuropathy. There is little literature available that addresses the management of this condition, which may partly explain why physiotherapy is often overlooked as a treatment approach in its management. This study investigated the effects of two manual therapy techniques in the treatment of patients experiencing carpal tunnel syndrome. An experimental different subject design compared three groups of subjects in three different conditions (two treatment interventions and one control group). Each group consisted of seven patients. The objectives of the study were: (1) to investigate differences between treated and untreated groups; (2) to investigate differences in the effectiveness of treatment I (median nerve mobilization) compared with treatment II (carpal bone mobilization). Measurements were taken applying several measurement tools, including active range of wrist movement (ROM flexion and extension), upper limb tension test with a median nerve bias (ULTT2a), three different scales to evaluate pain perception and function, and lastly numbers of patients continuing to surgery in each group were compared. In visual terms a clear trend was demonstrated between subjects who received treatment compared to those who were not treated, in particular the descriptive analysis of results for ULTT2a and numbers of patients continuing to surgery. When analysed statistically, less could be concluded. Only scores on a Pain Relief Scale (P<0.01) demonstrated highly significant differences between the three groups when analyzed using Kruskal-Wallis Test. In exploring the results of the two intervention groups, no statistically significant difference in effectiveness of treatment was demonstrated between carpal bone mobilization and median nerve mobilization.