Effectiveness of Nerve Gliding Exercises on Carpal Tunnel Syndrome

Nerve gliding may be a worthwhile add-on in the conservative management of carpal tunnel syndrome.  Here are a couple of videos showing how to do nerve gliding for CTS.

Carpal Tunnel Tendon Stretch and Nerve Gliding – Video – Fitzmaurice Hand Institute
Carpal Tunnel Nerve Gliding – Video – Leo Rozmaryn MD, Orthopedic Surgeon


J Manipulative Physiol Ther. 2017 Jan;40(1):50-59. doi: 10.1016/j.jmpt.2016.10.004. Epub 2016 Nov 11.

Ballestero-Pérez R1, Plaza-Manzano G2, Urraca-Gesto A3, Romo-Romo F3, Atín-Arratibel ML1, Pecos-Martín D4, Gallego-Izquierdo T4, Romero-Franco N5.

Abstract

OBJECTIVE:

The objective of this study was to review the literature regarding the effectiveness of neural gliding exercises for the management of carpal tunnel syndrome (CTS).

METHODS:

A computer-based search was completed through May 2014 in PubMed, Physiotherapy Evidence Database (PEDro), Web of Knowledge, Cochrane Plus, and CINAHL. The following key words were included: nerve tissue, gliding, exercises, carpal tunnel syndrome, neural mobilization, and neurodynamic mobilization. Thirteen clinical trials met the inclusion/exclusion criteria, which were: nerve gliding exercise management of participants aged 18 years or older; clinical or electrophysiological diagnostics of CTS; no prior surgical treatment; and absence of systemic diseases, degenerative joint diseases, musculoskeletal affectations in upper limbs or spine, or pregnancy. All studies were independently appraised using the PEDro scale.

RESULTS:

The majority of studies reported improvements in pain, pressure pain threshold, and function of CTS patients after nerve gliding, combined or not with additional therapies. When comparing nerve gliding with other therapies, 2 studies reported better results from standard care and 1 from use of a wrist splint, whereas 3 studies reported greater and earlier pain relief and function after nerve gliding in comparison with conservative techniques, such as ultrasound and wrist splint. However, 6 of the 13 studies had a quality of 5 of 11 or less according to the PEDro scale.

CONCLUSION:

Limited evidence is available on the effectiveness of neural gliding. Standard conservative care seems to be the most appropriate option for pain relief, although neural gliding might be a complementary option to accelerate recovery of function. More high-quality research is still necessary to determine its effectiveness and the subgroups of patients who may respond better to this treatment.