Neuropathy of the median nerve: clinical studies and application of a comprehensive rehabilitation programme using instrumented soft tissue mobilisation

Background. Median nerve neuropathy is one of the most common forms of peripheral nervous system disorders, which mostly manifests itself as carpal tunnel syndrome – compression-ischemic nerve damage in the carpal tunnel. This pathology is detected in about 3–5% of adults. The disease is more common in women – 2–3 times more often than in men, with a peak incidence between the ages of 40 and 60. Purpose – to evaluate the effectiveness of the method of instrumental soft tissue mobilisation (IASTM) in the treatment of median nerve neuropathy at different stages of the disease. Materials and Methods. As part of the treatment protocol, the technique of instrumentassisted soft tissue mobilisation (IASTM) was applied using specially designed manual instruments. The course of therapy consisted of 12 procedures performed three times a week for one month. The duration of each session varied between 20–25 minutes. The areas of treatment were the soft tissue structures of the forearm, hand (including the carpal tunnel), shoulder joint and cervical spine. Results. In the vast majority of patients (80–95%), there was a marked decrease in edematous manifestations and restoration of elasticity and mobility of soft tissue structures. Improvement of microcirculation created favourable conditions for activation of nervous tissue regeneration processes. After completion of the therapeutic course, Tinel’s and Phalen’s symptoms were no longer recorded in 85% of patients. An increase in hand muscle strength was recorded in 85–90% of cases. In addition, the data of the electroneuromyographic study showed positive dynamics – an increase in the amplitude of the M-response as an indicator of the functional state of neuromuscular transmission. Conclusions. The use of the IASTM technique in the treatment of median nerve neuropathy has demonstrated high clinical efficacy in restoring functional status and reducing clinical manifestations of the disease. After a four-week course of therapy, a significant improvement in the amplitude of active movements was recorded, which was confirmed by the relevant objective indicators. The method had a positive effect on the condition of the soft tissues in the affected area, helping to reduce muscle tone, improve elasticity and mobility. Patients reported a reduction in pain intensity, increased joint range of motion and improved overall functional level. The treatment was well tolerated, with no side effects or complications. Thus, IASTM can be considered a safe and effective tool in a comprehensive approach to the rehabilitation of patients with compression-ischemic median nerve injury, which helps to accelerate the recovery process and reduces the likelihood of the pathological process becoming chronic.