The Effectiveness of Carpal Bone Mobilization accompanied by Night Splinting in Idiopathic Carpal Tunnel Syndrome

Abstract

Objective: The aim of this study was to investigate the effectiveness of carpal bone mobilization (CBM) and night splinting and to compare it with night splinting as a control group in the treatment of Carpal Tunnel Syndrome (CTS). Methods: In the single-blind (assessor) prospective randomised controlled trial, a total of 40 patients with mild to moderate CTS were diagnosed by electroneuromyography (ENMG). In Group 1 (n=20), patients received CBM three times a week, total of 10 times, and used neutral volar wrist splint at night for 3 weeks. Patients in Group 2 (n=20) used only neutral volar wrist splint at night for 3 weeks. All of the patients were assessed at baseline and at the 3 rd month with respect to pain intensity using a numerical rating scale (0-10), handgrip and pinchgrip strength, functional status and symptom severity using the Boston Carpal Tunnel Questionnarie (BCTQ), and ENMG measurements. Results: There were improvements in all of the clinical variables, distal sensory latancy, and sensory nerve action potentials of the median nerve in Group 1. In Group 2, there was improvement in only BCTQ symptom severity and night/day pain intensity at the 3 rd month. Improvement in pinchgrip strength and BCTQ functional status were superior in Group 1 when compared to Group 2 at the 3 rd month. Conclusion: Both of the treatment modalities may be recommended for symptomatic relief. However, CBM combined with splinting may be a better choice for functional and strength amelioration as a non-invasive alternative treatment modality in CTS.