Introduction: Carpal tunnel syndrome is a compressive neuropathy, frequently seen in women. Conservative treatment for carpal tunnel syndrome focuses on control of symptoms and the nervous path, due to the possibility of double compression. Objective: To assess whether a protocol with emphasis on motor control techniques, including segmental cervical stabilization and neural mobilization, has better results in mechanical reorganization and reduction of symptoms when compared with classic therapeutic exercise techniques in the conservative treatment of carpal tunnel syndrome. Methods: This pilot study was a randomized, double-blind clinical trial, involving 11 women with an average age of 54 (± 6) years, allocated to either a classical kinesiotherapy group (CG) or experimental group (EG). The intervention spanned 12 weeks, with assessments prior to and following therapy, using the monofilament test, handgrip dynamometer, and BCTQ, DASH, and PRWE questionnaires. All normally distributed data was analysed with Student's T-tests. Results: Both groups exhibited an increase in grip strength and relief of symptoms with improved functionality. There was a significant reduction in sensitivity noted in the CG group, and a significant increase in grip strength observed in the EG group. Conclusion: The experimental protocol group exhibited better results in mechanical reorganization, reflected in increased strength, sensitivity, and improved functionality, when compared to the group with conventional therapeutic exercise, but without the same symptomatic reduction.

Objective: An emerging body of evidence suggests an association between pain and altered neural representations of the body. The integrity of these neural representations can be assessed with a timed motor imagery task such as the left/ right judgment task (LRJT). The purpose of this investigation was to systematically evaluate the literature and use meta-analytical methods to establish whether performance of the LRJT is impaired in people with upper limb pain. Materials and Methods: The literature was systematically searched across 8 databases for studies that reported use of the LRJT and also reported upper limb pain. Fifteen studies were found that included 6 upper limb pain conditions and 749 participants. Studies were grouped into 2 categories: (1) studies that compared response time and accuracy with healthy controls (between group comparison) and (2) studies that compared response time and accuracy for affected limb with the subject's healthy limb (within group comparison). Data were pooled, mean effect size calculated, and forest plots produced using RevMan 5.5. Results: Response times were slower in people with upper limb pain when compared with healthy controls (effect size: 1.42; 95% CI, 0.54 to 2.30). The pain group were also slower in identifying images corresponding to their painful limb than their healthy limb (effect size: 0.71; 95% CI, 0.24 to 1.17). Accuracy was reduced in people with upper limb pain compared with healthy controls (effect size: −0.76; 95% CI, −1.17 to −0.35). The pain group were also less accurate identifying images corresponding to their painful limb compared with the healthy limb (effect size: −0.63; 95% CI, −1.21 to −0.06). Conclusions: The findings of this meta-analysis and synthesis suggest that performance of the LRJT is impaired in people with upper limb pain conditions. Response times (RTs) are slower and accuracy is worse than healthy control subjects or healthy limbs. This reflects disturbances in cortical motor imagery processing and may indicate cortical changes associated with upper limb pain.