Effect of Fascial Mobilization Therapy on Pain, Grip Strength and Manual Dexterity in Patients With Postpartum Carpal Tunnel Syndrome

Carpal Tunnel Syndrome (CTS) is a pathological condition characterized by symptoms resulting from compression of the median nerve as it passes through the carpal tunnel. This syndrome is also known as compression neuropathy, the most common type of neuropathy in the upper extremities, and is reported to affect approximately 3% of the adult population. Entrapment neuropathies can affect a specific area of the nerve, but overall, this condition can lead to significant psychological, physical, and financial problems for the patient. The most common etiology of CTS is idiopathic; however, other possible causes include local (tenosynovitis, hypertrophic synovium, etc.), trauma including Colles' fracture, dislocation of the carpal bone(s), recent/malformed fracture near the wrist joint, anatomical anomalies, tumors, and regional and systemic factors. For example, occupational factors such as repetitive stress injuries to the flexor tendons of the hand, such as those seen in computer scientists, data entry clerks, typists, pianists, guitarists, sitarists, and fine art painters, may predispose to the development of CTS. Relevant literature indicates that CTS is three times more common in women than in men. It is known that the risk of CTS is significantly increased in individuals who work in repetitive and strenuous occupations. Furthermore, CTS is considered a common musculoskeletal problem during pregnancy. According to scientific data, the prevalence of CTS in the third trimester of pregnancy is approximately 63%. Approximately 53% of these cases are reported to be unilateral.

Causes of CTS during pregnancy include changes in the musculoskeletal system due to hormonal changes and edema that occur during pregnancy. Additionally, gestational diabetes can contribute to the development of CTS by causing a general slowing of nerve conduction velocity. Symptoms of CTS typically become more severe late in the day and may include pain, numbness, and tingling in the hand. The pain is usually felt along the median nerve path, but it can affect the entire hand and radiate to the arm and shoulder. Symptoms often begin with loss of sensation in the distal fingers. However, in more severe cases, muscle weakness and atrophy of the abductor pollicis brevis muscle, causing loss of palmar abduction of the thumb. CTS in pregnancy has generally been found to be less severe than non-pregnancy-related CTS. A study of both pregnant and non-pregnant women diagnosed with CTS found that pregnant patients recovered approximately 3 to 4 times faster than non-pregnant patients.

The aim of this randomized controlled trial was to investigate the effects of fascial mobilization therapy on pain, grip strength, and dexterity in patients with postpartum carpal tunnel syndrome.