Combined Physiotherapy with Electrotherapy and Neural Mobilization in Bilateral Carpal Tunnel Syndrome: A Case Report

Abstract

Background: Carpal tunnel syndrome is a common entrapment neuropathy caused by compression of the median nerve, resulting in pain, sensory disturbances, and functional limitations. Although conservative physiotherapy is widely used, evidence on combined electrotherapy and neural mobilization in individual clinical cases remains limited.

Objective: To describe the clinical outcomes of combined physiotherapy interventions in a patient with bilateral carpal tunnel syndrome.

Methods: This case report followed CARE guidelines. A 66-year-old female with bilateral wrist pain and sensory disturbances underwent a 4-week physiotherapy program consisting of transcutaneous electrical nerve stimulation, therapeutic ultrasound, nerve gliding, and strengthening exercises twice weekly. Outcomes included pain intensity (Numeric Rating Scale), muscle strength (Manual Muscle Testing), range of motion, and functional ability (Wrist Hand Disability Index). A reduction of at least 2 points in pain score was considered clinically meaningful.

Results: After 4 weeks, pain decreased from 5 to 2 during movement and from 4 to 2 on pressure, exceeding the minimal clinically important difference. Muscle strength improved from grade 3 to 5. Wrist range of motion increased bilaterally. Functional ability improved from 32% to 20%, indicating a shift from moderate to mild disability. No adverse events were reported.

Conclusion: Combined physiotherapy interventions were associated with clinically meaningful improvements in pain, strength, and function. Findings should be interpreted cautiously due to the single-case design.