The Effect of Carpal Tunnel Syndrome Phenotyping on Response to Treatment

People between the ages of 18-65, diagnosed with Carpal Tunnel Syndrome, who are suitable for the Neuropathic pain phenotype and who volunteer to participate in the study will be included. The 7 steps in the Clinical Criteria/Rating System for Carpal Tunnel Syndrome as defined by the International Association for the Study of Pain (IASP) will be applied to patients with CTS. After determining the dominant pain phenotype in patients with CTS, one group will consist of patients with homogeneous neuropathic pain phenotype (Group 1). The heterogeneous group will consist of patients with neuropathic and mixed pain phenotype (both neuropathic and nociplastic pain phenotype) (Group 2). Training, exercise, and wrist splinting will be applied to both groups. The training will include a presentation and booklet on the pathophysiology of CTS, treatment options (conservative treatment and surgery), posture and activity modification principles. Participants will be given a programme of median nerve sliding and tendon sliding exercises as home exercises. The numerical rating scale (NRS) scale will be used for pain assessment. Boston Carpal Tunnel Questionnaire - Symptom Severity Scale, Boston Carpal Tunnel Questionnaire - Functional Status Scale, Michigan Hand Results Questionnaire (MHQ) will be used. Normality of data distribution will be assessed using the Shapiro-Wilk test. Fisher's exact test and chi-square test will be used to verify the relationship between categorical variables. A mixed model ANOVA will be performed on 2 (group 1 and group 2) x 3 (time: baseline, week 6 and week 12) different outcome measures (pain intensity, symptom severity, functional status, Michigan Hand Results Questionnaire (MHQ)) to detect between-group differences.