EFFECTS OF DEEP TRANSVERSE FRICTION MASSAGE ALONG WITH NERVE GLIDING EXERCISES IN THE MANAGEMENT OF CARPAL TUNNEL SYNDROME PATIENTS

Background: Carpal Tunnel Syndrome (CTS) is a prevalent condition characterized by discomfort, pain, and functional impairment due to median nerve compression. Conservative treatment approaches aim to manage symptoms and improve functionality. Among these, manual therapies such as Deep Transverse Friction Massage (DTFM) and Nerve Gliding Exercises (NGEs) have shown promise in addressing both neural and mechanical dysfunctions. This study evaluates the combined effects of DTFM and NGEs in alleviating CTS symptoms and enhancing functional outcomes. Objective: To investigate the effects of Deep Transverse Friction Massage combined with Nerve Gliding Exercises in the management of Carpal Tunnel Syndrome. Methods: This randomized clinical trial employed a non-probability purposive sampling technique to recruit 56 participants aged 20–40 years with CTS, confirmed by positive Phalen’s, Tinel’s, and Duncan’s tests, and moderate pain levels (VAS 4–7). Patients were randomly assigned to Group A (DTFM + NGEs) or Group B (NGEs alone). The intervention spanned four weeks, with two sessions per week. Outcome measures included pain (Visual Analog Scale), wrist range of motion (goniometer), grip strength (handheld dynamometer), and functional disability (Boston Scale). Statistical analyses were conducted using SPSS version 20, employing the Friedman test for intragroup analysis and the Mann-Whitney U test for intergroup comparisons. Results: Group A showed significant improvements across all variables compared to Group B. Pain reduction demonstrated a highly significant difference (p < 0.000) post-intervention, with improved wrist flexion (p = 0.05) and extension (p = 0.056). Grip strength increased significantly (p < 0.000), and functional disability scores were notably better in Group A (p < 0.000). The findings indicate the superior efficacy of the combined intervention over nerve gliding exercises alone. Conclusion: The combination of Deep Transverse Friction Massage and Nerve Gliding Exercises proved significantly more effective than NGEs alone in managing pain, improving wrist mobility, enhancing grip strength, and reducing functional disability in patients with Carpal Tunnel Syndrome.