Comparison of Manual Therapy and Neurodynamic Techniques in Patients with Carpal Tunnel Syndrome: A Quasi-Experimental Study

Abstract

Background: Carpal tunnel syndrome is a common median nerve entrapment neuropathy that affects hand sensation, functional activity, and quality of life. Manual therapy and neurodynamic mobilization are commonly used conservative interventions, but direct comparative evidence remains limited. Objective: To compare the short-term effects of manual therapy plus electrotherapy and median nerve neurodynamic mobilization plus electrotherapy on symptom severity and functional status in patients with carpal tunnel syndrome. Methods: This quasi-experimental study included 16 participants with carpal tunnel syndrome who were allocated equally into two groups. Group A received manual therapy with TENS and EMS, while Group B received median nerve neurodynamic mobilization with TENS and EMS. Treatment was provided three to four times per week for two weeks. Outcomes were assessed using the Boston Carpal Tunnel Questionnaire at baseline, Week 1, and Week 2. Data were analyzed using SPSS version 21, with p < 0.05 considered statistically significant. Results: Both groups showed significant within-group improvement in symptom severity and functional status over two weeks. Symptom severity decreased from 1.78 ± 0.69 to 0.52 ± 0.47 in the neurodynamic group and from 1.92 ± 0.61 to 0.57 ± 0.50 in the manual therapy group. Functional status decreased from 2.02 ± 0.85 to 0.47 ± 0.64 and from 2.19 ± 0.94 to 0.55 ± 0.80, respectively. Week-2 between-group differences were not statistically significant for symptom severity (p = 0.854) or functional status (p = 0.833). Conclusion: Both combined rehabilitation approaches were associated with short-term improvement, with no statistically detectable difference between groups. Larger randomized trials are needed to confirm comparative effectiveness.