Comparison of the Effectiveness of Myofascial Release with Neural Mobilization versus Exercise Program with Ultrasonic Therapy in Carpal Tunnel Syndrome: A Randomized Comparative Study

Background: Carpal Tunnel Syndrome (CTS) is a common peripheral nerve entrapment disorder caused by compression of the median nerve at the wrist, commonly associated with repetitive hand activity, prolonged computer use, and poor ergonomic posture, leading to pain, numbness, reduced grip strength, and functional limitation. Objective: To compare the effectiveness of Myofascial Release combined with Neural Mobilization (Group A) against an Exercise Program combined with Ultrasonic Therapy (Group B) in individuals with Carpal Tunnel Syndrome. Methods: In this experimental comparative study, 60 participants aged 30–45 years with mild-to-moderate, ergonomics-related CTS were randomly allocated in a 1:1 ratio to Group A (Myofascial Release + Neural Mobilization, n = 30) or Group B (Exercise Program + Ultrasonic Therapy, n = 30) for 4 weeks. Pain, grip strength, and functional ability were assessed using the Visual Analogue Scale (VAS), a hand dynamometer, and the Boston Carpal Tunnel Questionnaire–Functional Status Scale (BCTQ-FSS) at baseline and post-treatment. Results: Both groups improved significantly on all outcome measures from baseline to post-treatment (all p < 0.001). Group A showed significantly greater improvement than Group B on VAS, grip strength, and BCTQ-FSS at post-treatment (all p < 0.001), with very large between-group effect sizes (d = 4.57 to 5.52). Conclusion: Myofascial Release combined with Neural Mobilization produced significantly greater improvement in pain, grip strength, and functional status than an Exercise Program combined with Ultrasonic Therapy, in individuals with Carpal Tunnel Syndrome, over a 4-week period. These findings support Myofascial Release plus Neural Mobilization as an effective conservative treatment option, pending confirmation in a larger, multi-centre, blinded trial with objective neurophysiological outcome measures. Trial registration: This trial was not prospectively registered in a clinical trials registry; this is noted as a limitation of reporting.