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Dry needling is used for myofascial release. However, its effectiveness in carpal tunnel syndrome (CTS) is not well known. It is thought that dry needling may also be an effective treatment for CTS by providing relaxation in the fascial tissue. Therefore, this study will examine the effects of dry needling treatment on pain, function, range of motion, proprioception and disability in patients with CTS.
Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy in the society, which develops due to compression of the median nerve in the carpal tunnel. With the compression of the median nerve, a pain, numbness and tingling sensation spreading to the hand and wrist affects daily living activities and reduces the quality of life. Thickening and myofascial restriction in the carpal tunnel area also contribute to this situation. For this reason, various treatment methods have been developed for CTS, ranging from conservative treatment to surgery. Dry needling is also an alternative treatment method that can be used for CTS. Dry needling allows the fascial tissue to loosen and re-enter the healing process, leading to a decrease in pain and an increase in quality of life. However, its effectiveness in patients with CTS is unknown. This study aimed to examine the effectiveness of dry needling in patients with CTS.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Treatment Group | Experimental | In addition to the exercise given to the control group, the treatment group will receive dry needling in the carpal tunnel area, 2 days a week for 3 weeks, for a total of 5 sessions. |
|
| Control Group | Active Comparator | The control group will be taught and asked to perform stretching, nerve mobilization and tendon-shifting exercises for 3 weeks. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Dry needling | Other | In addition to stretching, nerve mobilization and tendon gliding exercises, a total of 5 sessions of dry needling will be performed for fascial mobilization, 2 days a week for 3 weeks. |
| Measure | Description | Time Frame |
|---|---|---|
| Pain severity | It will be evaluated with the Visual Analogue Scale. The scale ranges from 1 to 10 at 10 mm intervals. 0 indicates absence of pain and the highest value of 10 indicates extreme pain. | Baseline and 3 weeks post-intervention |
| Wrist range of motion | Wrist flexion, extension, ulnar deviation and radial deviation joint range degrees will be measured using a universal goniometer. | Baseline and 3 weeks post-intervention |
| Position sense | In the evaluation of joint position sense (proprioception), wrist extension, elbow flexion and shoulder flexion movements will be evaluated with an inclinometer. An increase in deviation from the target angle indicates a worsening of position sense. | Baseline and 3 weeks post-intervention |
| Severity of symptoms | The patients' CTS-related symptom severity and functional status will be evaluated with the Boston Carpal Tunnel Syndrome Questionnaire. The severity of the patient's strain is scored between 1-5. Higher scores indicate greater disability. | Baseline and 3 weeks post-intervention |
| Hands activity level | Duruöz hand index will be used to evaluate hand-related activity limitations. The survey yields a total score of 0-90, with a higher score indicating greater activity restriction. | Baseline and 3 weeks post-intervention |
| Nerve cross-sectional area | With ultrasonography, the doctor will measure the median nerve cross-sectional area of the individual and the distance between the median nerve flexor retinaculum. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Fidan Yılmaz, MsC | Pursaklar State Hospital | Principal Investigator |
| Emime EMÄ°RMAHMUTOÄžLU, Bachelors | Pursaklar State Hospital | Principal Investigator |
| Banu Gökçen BAYDOĞAN TAN, MD | Pursaklar State Hospital | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Pursaklar State Hospital | Ankara | Turkey (Türkiye) |
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| ID | Term |
|---|---|
| D002349 | Carpal Tunnel Syndrome |
| D005157 | Facial Pain |
| ID | Term |
|---|---|
| D020423 | Median Neuropathy |
| D020422 | Mononeuropathies |
| D010523 | Peripheral Nervous System Diseases |
| D009468 | Neuromuscular Diseases |
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| ID | Term |
|---|---|
| D000079245 | Dry Needling |
| D035061 | Control Groups |
| ID | Term |
|---|---|
| D000529 | Complementary Therapies |
| D013812 | Therapeutics |
| D026741 | Physical Therapy Modalities |
| D015340 | Epidemiologic Research Design |
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Parallel Assignment
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Triple-blind study; the patients will not be informed about their groups (training group or the control group) and they will be evaluated and trained at different places and times.
| Control group | Other | The physiotherapist will teach stretching, neuromobilization and tendon shifting exercises and will be asked to do them regularly for 3 weeks. |
|
| Baseline and 3 weeks post-intervention |
| D009422 | Nervous System Diseases |
| D009408 | Nerve Compression Syndromes |
| D012090 | Cumulative Trauma Disorders |
| D013180 | Sprains and Strains |
| D014947 | Wounds and Injuries |
| D010146 | Pain |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D004812 | Epidemiologic Methods |
| D008919 | Investigative Techniques |
| D012107 | Research Design |
| D008722 | Methods |