Mechanisms of Neurodynamic Treatments

Launched by UNIVERSITY OF OXFORD · May 4, 2023

Keywords

ClinConnect Summary

This clinical trial is studying the effects of a specific type of physiotherapy called neurodynamic exercises on patients with mild to moderate carpal tunnel syndrome (CTS). CTS happens when a main nerve in the wrist gets pressed, causing pain and discomfort. The researchers want to understand how these exercises help improve nerve function and reduce symptoms in comparison to steroid injections and general advice. The goal is to find out exactly how these treatments work, which could help doctors choose better options for their patients.

To participate, you need to be 18 years or older and diagnosed with mild to moderate CTS. If you have not had surgery for CTS or a steroid injection in the last six months, you may be eligible. Participants will be placed in one of three groups: those doing neurodynamic exercises, those receiving a steroid injection, or those getting general advice. Throughout the study, participants will complete various assessments, including MRI scans and questionnaires about pain and function, to see how effective the treatments are. It's important to know that the trial is still recruiting, so if you're interested, you could be part of this important research!

Gender

ALL

Eligibility criteria

• • Inclusion Criteria
• Patients:
• • 1. Patients who have a diagnosis of mild to moderate carpal tunnel syndrome based on a clinical assessment and confirmed with nerve conduction studies.
• • 2. Male or Female, aged 18 years or above.
• • 3. Patient is willing and able to give informed consent for participation in the study.
• Healthy participants:
• • 1. Male or female aged 18 years or above.
• • 2. Participant is willing and able to give informed consent for participation in the study.
• • 3. No history of hand or arm symptoms
• • 4. No history of neck pain in the past 3 months
• • 5. No systemic medical condition
• • 6. No strong anticoagulant medication or altered coagulation (e.g., hemophilia) preventing skin biopsies
• • 7. Severe anxiety or depression
• • 8. Participants are required to be age- \& sex-matched to patient participants
• • 9. No contraindications for magnetic resonance scanning at 3T
• • 10. Sufficient command of the English language
• • Exclusion Criteria
• Patients:
• • 1. Patients who already had surgery for their carpal tunnel syndrome (CTS) or are planning to undergo surgery in the next 6 weeks (patients with unilateral surgery who have unoperated CTS on the other hand are eligible to participate)
• • 2. Patients who had a steroid injection for their CTS in the 6 months prior to the study enrolment or who had already more than 1 steroid injection into the study wrist.
• • 3. Patients who have a diagnosis of severe carpal tunnel syndrome based on a clinical assessment and confirmed with electrodiagnostic testing
• • 4. Electrodiagnostic testing revealing abnormalities other than CTS
• • 5. Any other upper limb or neck problem for which they have sought treatment in the past 3 months
• • 6. History of significant trauma to the upper limb or neck
• • 7. Diabetes
• • 8. Hypothyroidism
• • 9. Severe anxiety or depression
• • 10. Patient who is pregnant, lactating, or planning pregnancy during the study.
• • 11. Patients on strong anticoagulant medication or altered coagulation preventing skin biopsies.
• • 12. Contraindications for magnetic resonance imaging (assessed with MRI safety screening questionnaire).
• • 13. Contraindications for steroid injections
• • 14. Insufficient command of the English language