Effect of Myofascial Release Versus Acupressure on Carpal Tunnel Syndrome in Postnatal Period

Effect of Myofascial Release Versus Acupressure on Carpal Tunnel Syndrome in Postnatal Period

This study will be conducted to compare the effect of myofascial release and acupressure on postnatal carpal tunnel syndrome.

Various factors, such as an increase in body mass index (BMI), hormones (relaxin), fluid redistribution, and maternal age, are involved in the etiology of pregnancy related carpal tunnel syndrome (CTS). In terms of prognosis, although it has been reported that pregnancy related CTS generally regresses completely spontaneously or with conservative treatment methods after birth, residual symptoms and neurophysiological findings that require surgical decompression up to a year after birth have also been reported.

In clinical practice guidelines, conservative treatment is recommended for mild and moderate cases, while a surgical approach is recommended for patients with severe CTS . Some clinical conditions such as hormonal alteration and edema for menopause and pregnancy due to alteration of the fluid balance in the body.

Myofascial release is considered a safe, non-invasive, and simple method for decreasing pain intensity and numbness sensation severity and for improving hand function in pregnant women with CTS.

Acupressure is the supportive therapies based on Chinese medicine. Pressure is applied to the affected areas without the use of needles. PC7 or the Daling point is especially considered when managing CTS; it was found to cause an increase of endomorpin-1, beta-endorphin, serotonin, dopamine, and enkephalin levels in the brain tissues and plasma. Acupressure was found to be more effective compared to the placebo and splints re- garding the functional status and nerve conduction studies.

Inclusion Criteria:

• Postpartum women with mild to moderate carpal tunnel syndrome (CTS).
• Their ages will range from 25 to 35 years old.
• Their body mass index (BMI) will range from 25 to 30 Kg/m2.
• The electrophysiological evidence of mild or moderate median nerve lesion at wrist (mild: sensory nerve conduction velocity slow on finger/wrist measurement, sensory nerve latency >3.5 ms, normal terminal motor latency; moderate: sensory potential preserved with motor slowing, distal motor latency to abductor pollicis brevis (APB) < 6.5 ms)
• Positive phalen's test.
• Positive tinel's test.
• Unilateral or bilateral carpal tunnel affection will be included.

Exclusion Criteria:

• History of brachial plexopathy or malignancy.
• Radial, ulnar neuropathy, proximal median neuropathy or polyneuropathy.
• Previous wrist surgery or steroid injection for CTS.
• History of trauma, fracture, deformity or inflammation in the wrist, such as rheumatoid arthritis.
• Coagulation abnormalities, pregnancy, fever and infections.
• Skin disease and skin cancer.
• Spots, birthmarks or tattoos over the work points.
• Pacemaker and implementable medical devices.