The Impact of Lymphatic Drainage and Nerve Mobilization Techniques on Nerve Morphology in Mild-to-Moderate Carpal Tunnel Syndrome: A Randomized Controlled Trial

Abstract

Objective

To investigate whether nerve mobilization related to nerve mobility or the removal of edema using lymphatic drainage affects the cross-sectional area of the nerve, hand function, and symptom severity in carpal tunnel syndrome.

Design

The study is a prospective randomized controlled trial. Data were analyzed between groups using ANOVA, Chi-squared test, and Kruskal–Wallis test.

Setting

Treatment lasted 4 weeks. Splint group wore the splint daily. Splint+manual lymphatic drainage received lymphatic drainage 5 days a week. Splint+nerve mobilization performed neuromobilization exercises as home exercises 5 days a week. Evaluations were conducted before and after 4 weeks of treatment.

Participants

The study included 80 patients with mild-to-moderate carpal tunnel syndrome.

Interventions

The patients were randomly divided into three groups: splint (n = 27), splint+manual lymphatic drainage (n = 27), or the splint+nerve mobilization (n = 26).

Main Outcome Measures

The main outcome measures were ultrasound assessments and the Boston Carpal Tunnel Questionnaire (Symptom Severity Scale and Boston Functional Status Scale).

Results

Compared to the other groups, the nerve cross-sectional area decreased at both the carpal tunnel (p = 0.003) and mid-forearm (p = 0.014) levels in the drainage group. Nerve mobilization did not result in a significant change in the nerve cross-sectional area. All groups showed significant improvements in both symptom severity and functional status scores (p < 0.001).

Conclusion

The reduction of edema through lymphatic drainage contributes to a decrease in the cross-sectional area of the median nerve. Additionally, all three methods appear to positively impact the functional capacity of the hand and alleviate symptoms.