A Multimodal approach of electrotherapy versus nerve flossing technique in patients with chronic carpal tunnel syndrome: a randomized controlled trial

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Fatma Seddik Amin
Heba Ahmed Abd El_Azeem Haridy
Ebtesam Mohamed Fahmy
Yasser Ramzy Lasheen


multimodal approach, nerve flossing technique, carpal tunnel syndrome


Background: The median nerve becomes trapped at the level of the wrist in the condition known as carpal tunnel syndrome (CTS), which has a substantial impact on hand functions. Objectives: To assess the impact of the multimodal electrotherapy and nerve flossing technique on patients with chronic CTS on pain intensity, pinch grip power, hand function status, symptom severity, and sensory and motor distal lantenies
Design: A randomized controlled trial conducted in a single-blind technique.
Methods: In this study, 51 female cases, aged 30-45, with unilateral mild to moderate CTS in their dominant hand took part. They were divided into three groups at random. Cases in Group A (the experimental group, n = 17) underwent multimodal electrotherapy (low-level laser therapy, interferential therapy, and ultrasound) plus conventional therapy, including a splint and therapeutic exercises. Cases in Group B (the experimental group, n = 17) obtained median nerve flossing in addition to conventional therapy. Cases in Group C (the control group, n = 17) got typical rehabilitative exercises and wore a splint. Every treatment session took place three days a week for eight weeks. Measurements were taken to compare the results before and after the treatment.
Outcome measures: A visual analog pain scale was utilized to assess pain level, a baseline hydraulic pinch dynamometer was used to measure pinch power, hand function status, and symptom severity using the Boston Carpal Tunnel Questionnaire, and electromyography was used to measure the median nerve's sensory and motor distal latencies.
Results: There was no significant difference between the effects of the multimodal electrotherapy approach (group A) and the median nerve flossing technique (group B) on pain intensity level, pinch grip strength, hand function status, symptom severity, sensory, and motor distal latencies. However, these turned out to be more effective than traditional therapeutic exercises (Group C). 

Conclusions: In accordance with the outcomes of the current study, patients with chronic CTS respond well to the multimodal electrotherapy method and the median nerve flossing technique.

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