Neurodynamic techniques vs. desensitization maneuvers in the manual therapy management of moderate carpal tunnel syndrome among women: randomized clinical trial with 1-year follow-up

Objective This study aimed to compare the clinical and electrophysiological effects of neurodynamic techniques vs. desensitization maneuvers in women with moderate carpal tunnel syndrome (CTS). Design Randomized clinical trial. The study included 380 female participants with moderate carpal tunnel syndrome, aged between 45 and 55 years, who were randomly assigned to a neurodynamic technique group or a desensitization maneuvers group. Neurodynamic techniques in one group and desensitization in the other group were conducted for 3 months. Outcome Measures were nerve conduction, pain, symptom severity, and functional status using the Boston Carpal Tunnel Questionnaire, and cylindrical and pincer grip strength before treatment and after 3 months of treatment. One-year follow-up for pain, symptom severity, and functional status using the Boston Carpal Tunnel Questionnaire. Results Both groups demonstrated significant within-group improvements in nerve conduction, pain, symptom severity, and functional status ( P < 0.001). Between-group analysis showed greater improvements in sensory and motor nerve conduction, pain, symptom severity, and functional status in the desensitization group ( P < 0.001). Improvements in cylindrical and pincer grip strength were significant only in the desensitization group. Clinical gains in pain and function were maintained at 1-year follow-up. Conclusion Both interventions were effective in women with moderate CTS; however, desensitization maneuvers demonstrated superior improvements in neurophysiological outcomes, pain, and function over 12 weeks, with sustained benefits at 1-year follow-up. Clinical Trial Registration: http://www.clinicaltrials.gov/ , NCT05150912.