Effects of Manual Therapy on Pain Perception in Individuals with Carpal Tunnel Syndrome

Relevance: Hand osteoarthritisis a highly prevalent diseasewith clinical and social burdens.Therapists need to understandthe current levels of evidencethat support the interventionsthey are using in the treatmentof hand osteoarthritis.

Research/Evidence-BasedPractice

KRISTIN A. VALDES, OTD, OTR,CHT

Effects of Manual Therapy onPain Perception in Individualswith Carpal Tunnel Syndrome.

1: Identify the difference be-tween a direct neural mobiliza-tion technique and a sham neuralmobilization technique. 2:Describe that immediate clinicaloutcome did not differ based ontype of neural mobilization tech-nique used to treat carpal tunnelsyndrome.

428 JOURNAL OF HAND THERAPY

Purpose: We present preliminaryfindings of the effects of neuralmobilization (NM) on pain per-ception in individuals diagnosedwith carpal tunnel syndrome.

Methods: Participants were ran-domly assigned to receive eitherdirect NM or a sham NMMechanical visual analog scales(MVAS) and 101 point numericrating scales (NRS) were usedduring the first treatment sessionto quantify self report of currentcarpal tunnel pain and the per-ception of standardized painfulthermal stimuli. Repeated mea-sure ANOVAs were used to eval-uate pain perception prior to andimmediately following theintervention.

Results: Thirty three individ-uals met the criteria and agreedto participate. A main effect waspresent for self report of currentpain (F(1,31)¼ 4.40, p¼ 0.04, par-tial h2¼ 0.12) with a mean de-crease of 6.09 mm; however, thiswas independent of group assign-ment (p¼ 0.72). Pain perception

to standardized thermal stimulidid not decrease over time or differby group assignment (p . 0.05).

Conclusion: Self report of painspecifically related to carpaltunnel syndrome was lessenedimmediately following a NM in-tervention regardless of whetherthe intervention was specific tothe median nerve or not.Perceptions of standardized ther-mal pain stimuli were not alteredby either NM technique.

Clinical Relevance: The resultsprovide preliminary supportthat the influence of NM on CTSself report of pain may be inde-pendent of the specificity of thetechnique used. Instead, pain re-lief may result from non- specificeffects of treatment.

Research/Evidence-BasedPractice

STEVEN GEORGE, PT, PHDJOEL E. BIALOSKY, MS, PTMARK D. BISHOP, PT, PHDMICHAEL E. ROBINSON, PHD

DONALD D. PRICE, PHD