The Effect of Longitudinal Stretching of Muscles and Nerve versus Deep Transverse Friction Massage in the Management of Patients with Carpal Tunnel Syndrome

Abstract

Background and Purpose: Carpal tunnel syndrome (CTS) is a common source of hand numbness and pain. The goal of this study was to compare longitudinal stretching of muscles and nerve to deep transverse friction massage for decreasing pain and improving hand function in patients with chronic CTS. Subjects and Methods: Thirty patients, 25 to 40 years old, were included in this study and randomized into two groups: the first group (36.8 ± 0.262) followed a physical therapy program group receiving stretching of wrist and hand flexors in combination with ultrasound, strengthening exercises of wrist and hand flexors, and wrist splint, three sessions per week for 12 weeks; and the second group (35.9 ± 0.225) followed the physical therapy program of deep trans-verse friction massage on the carpal tunnel site at the wrist joint, with using ultrasonic therapy, strengthening exercises of wrist and hand flexors and wrist splint, three sessions per week for 12 weeks. Outcome measures were range of motion (ROM), pain using visual analog scale (VAS), and hand grip strength measured with a sphygmomanometer. Results: There was a significant differ-ence in both groups in all outcome measures compared to baseline. Over stretching group showed significant difference at the end of study in terms of range of motion of wrist flexion, extension and strength of handgrip when compared to deep friction massage group P < 0.05. However, there is no significant difference between groups in pain. Discussion and Conclusion: This study showed A. R. Hafez et al. 200 that the effect of stretching exercises is more beneficial than deep transverse friction massage in the treatment of patients with CTS in decreasing the compression of the median nerve in the tun-nel.