Neurodynamic Techniques Versus “Sham” Therapy in the Treatment of Carpal Tunnel Syndrome: A Randomized Placebo-Controlled Trial

Abstract

ObjectiveTo evaluate the efficacy of neurodynamic techniques used as the sole therapeutic component compared with sham therapy in the treatment of mild and moderate carpal tunnel syndromes (CTS). DesignSingle-blinded, randomized placebo-controlled trial. SettingSeveral medical clinics. ParticipantsVolunteer sample of patients (N=250) diagnosed with CTS (n=150). InterventionsNeurodynamic techniques were used in the neurodynamic techniques group, and sham therapy was used in the sham therapy group. In the neurodynamic techniques group, neurodynamic sequences were used, and sliding and tension techniques were also used. In the sham therapy group, no neurodynamic sequences were used, and therapeutic procedures were performed in an intermediate position. Therapy was conducted twice weekly for a total of 20 therapy sessions. Main Outcome MeasuresSymptom severity (symptom severity scale) and functional status (functional status scale) of the Boston Carpal Tunnel Questionnaire. ResultsA baseline assessment revealed no intergroup differences in all examined parameters (P>.05). After therapy, there was statistically significant intragroup improvement in nerve conduction study (sensory and motor conduction velocity and motor latency) only for the neurodynamic techniques group (P<.01). After therapy, intragroup statistically significant changes also occurred for the neurodynamic techniques group in pain assessment, 2-point discrimination sense, symptom severity scale, and functional status scale (in all cases P<.01). There were no group differences in assessment of grip and pinch strength (P>.05). ConclusionsThe use of neurodynamic techniques has a better therapeutic effect than sham therapy in the treatment of mild and moderate forms of CTS.