title: Response of pain intensity to soft tissue mobilization and neurodynamic technique: a series of 18 patients with chronic carpal tunnel syndrome.
abstract: OBJECTIVE
  The purpose of this prospective case series was to examine the combined effects of soft tissue mobilization and nerve slider neurodynamic technique on pain and pressure sensitivity in women with chronic carpal tunnel syndrome (CTS).
  
  
  METHODS
  Eighteen women with a clinical and electromyographic diagnosis of CTS participated. Patients completed the numerical pain rating scale (NPRS) for current, worst, and lowest pain intensity and underwent pain pressure threshold (PPT) testing over the median, radial, and ulnar nerves; the C5-C6 zygapophyseal joint; the carpal tunnel; and the tibialis anterior muscle. Pain was assessed at baseline and 1-week follow-up, whereas PPT were assessed at baseline and immediately after and 1-week after intervention. Each received soft tissue mobilization and nerve slider neurodynamic technique directed at different anatomical sites of potential entrapment of the median nerve.
  
  
  RESULTS
  A decrease in the mean current intensity and worst level of hand pain (P<.01) was found 1 week after the treatment session (mean changes, 2.2±1.1 points). A treatment effect for PPT levels over the C5-C6 zygapophyseal joint (P<.001) was found: PPT increased bilaterally 1 week after the intervention. No other significant changes in PPT levels were found (P>.195).
  
  
  CONCLUSIONS
  The application of soft tissue mobilization and neurodynamic technique decreased the intensity of pain but did not change pressure pain sensitivity in this group of women with chronic CTS.
authors.affiliation: Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos, Alcorcón, Spain.
authors.forename: Ana I
authors.initials: AI
authors.lastname: De-la-Llave-Rincon
authors.forename: Ricardo
authors.initials: R
authors.lastname: Ortega-Santiago
authors.forename: Silvia
authors.initials: S
authors.lastname: Ambite-Quesada
authors.forename: Antonio
authors.initials: A
authors.lastname: Gil-Crujera
authors.forename: Emilio J
authors.initials: EJ
authors.lastname: Puentedura
authors.forename: Marie C
authors.initials: MC
authors.lastname: Valenza
authors.forename: César
authors.initials: C
authors.lastname: Fernández-de-las-Peñas
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D002349:Carpal Tunnel Syndrome / Q000150:complications / Q000175:diagnosis / Q000534:rehabilitation*; D002908:Chronic Disease; D015331:Cohort Studies; D004576:Electromyography / Q000379:methods; D005260:Female; D006801:Humans; D020393:Manipulation, Spinal / Q000379:methods; D008405:Massage / Q000379:methods; D008875:Middle Aged; D026201:Musculoskeletal Manipulations / Q000379:methods*; D010146:Pain / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D010147:Pain Measurement / Q000379:methods*; D017288:Pain Threshold / Q000502:physiology*; D017060:Patient Satisfaction; D010812:Physical Stimulation / Q000379:methods; D011446:Prospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome