Fernández-de-Las Peñas C, Ortega-Santaigo R, de la Liave-Rincón A, et al. Manual physical therapy versus surgery for carpal tunnel syndrome: a randomized parallel-group trial.J Pain. 2015;16(11): 1087-1094. doi:10.1016/j.jpain.2015.07.012 

Although nonsurgical approaches to manage carpal tunnel syndrome (CTS) can be beneficial in the short term, medium- and long-term effects are largely unknown. Researchers in Spain conducted a pragmatic, parallel-group, randomized clinical trial to compare the effectiveness of surgery with physical therapy involving manual manipulations to manage symptoms in participants with CTS. 

The researchers recruited women with a diagnosis of CTS, with pain and paresthesia that increased at night, and positive Tinel and Phalen signs that were present for more than 12 months. Participants were excluded if they were older than 65 years or if they had ulnar or radial nerve sensorimotor deficits; systemic disease; trauma to the cervical region, shoulder, and upper extremities; other upper extremity conditions; musculoskeletal conditions; or depression.