Overview

This randomized, parallel-group controlled clinical trial aims to investigate the effects of adding cervicothoracic exercises to conventional physiotherapy on pain, functional status, grip strength, and range of motion in individuals with carpal tunnel syndrome (CTS). CTS is a common compressive neuropathy of the median nerve, characterized by pain, numbness, tingling, nocturnal symptoms, and reduced hand function. Sixty adults diagnosed with CTS will be randomly allocated into two groups (n=30 each): a conventional physiotherapy group and a cervicothoracic exercise plus conventional physiotherapy group.

The conventional physiotherapy program includes transcutaneous electrical nerve stimulation (TENS), therapeutic ultrasound, median nerve mobilization, wrist range-of-motion exercises, and strengthening exercises. The intervention group will receive the same conventional physiotherapy program in addition to cervicothoracic exercises targeting cervical mobility, scapular stabilization, and thoracic spine mobility. The intervention will be applied five days per week for six weeks.

Outcome measures will be assessed at baseline and at the end of week 6. Primary outcomes include pain intensity measured by the Visual Analog Scale (VAS), functional status assessed using the Boston Carpal Tunnel Questionnaire (BCTQ), and grip strength measured with a Jamar hand dynamometer. Secondary outcomes include upper extremity function evaluated using the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire and wrist and finger range of motion measured with a goniometer. Data will be analyzed using appropriate statistical methods, with statistical significance set at p\<0.05. This study aims to determine whether adding cervicothoracic exercises to conventional physiotherapy provides additional clinical benefits in CTS rehabilitation.

Eligibility

Inclusion Criteria:

• Age over 18
• Symptom duration of at least 12 weeks,
• Information about carpal tunnel syndrome received from a physician,
• Positive Tinel or Phalen test in carpal compression test,
• Pain intensity, Visual Analog Scale, at least 40 mm out of 100 mm

Exclusion Criteria:

• Any sensory or motor deficit in the ulnar or radial nerve
• History of previous surgery or injection in the wrist
• Trauma to the neck, shoulder, or upper extremity
• Pregnancy
• Concurrent cervical radiculopathy or polyneuropathy