The Effectiveness of Pain Neuroscience Education for Patients With Carpal Tunnel Syndrome

Karamanoğlu Mehmetbey University

Status: Enrolling

Conditions: Carpal Tunnel Syndrome (CTS)

Treatments: Other: Exercise; Behavioral: Pain neuroscience education

Study type: Interventional

Funder types: Other

Identifiers

NCT07302282

25-2025/12

Details and patient eligibility

About

The goal of this clinical trial is to investigate the effects of Pain Neuroscience Education applied in the treatment of mild and moderate carpal tunnel syndrome (CTS).

The main question it aims to answer is: Does PNE have a therapeutic effect on carpal tunnel syndrome in clinical and ultrasonographic terms? Researchers will compare whether PNE creates a synergistic effect alongside home based exercise programs and splint application in mild to moderate CTS, and will objectively demonstrate potential benefits such as relief from pain and numbness.

Full description

Carpal Tunnel Syndrome (CTS) is a common compressive neuropathy of the median nerve that presents with symptoms of numbness and tingling in the median nerve distribution of the hand. If symptoms are not treated early, they become chronic. Factors affecting the severity of chronic pain include; biological, psychological and social/environmental etc.

Pain neuroscience education is a treatment strategy that aims to teach patients about the effects of their beliefs and behaviors on the formation of their pain experiences. This education focuses on the role of the central nervous system in pain by raising awareness about the neurobiology and neurophysiology of pain. It focuses on remodelling the behavioral approach to pain perception rather than anatomical damage. This approach aims to reduce patients' fear and catastrophizing by helping them better understand pain. Various metaphors, examples, and visuals are used during PNE to help patients understand pain mechanisms. PNE is thought to have an impact not only on pain but also on disability, functionality, and quality of life. PNE has been documented to have a positive effect not only on pain but also on other important factors such as disability, functionality, and quality of life.

A clinical study has shown that adding PNE to a telerehabilitation program has some positive effects, such as a reduction in symptom severity in patients with carpal tunnel syndrome. However, the number of studies in the literature on the efficacy of PNE in carpal tunnel syndrome is limited to a single study and is based on subjective methods such as patient statements. Unlike the previous study, this study will use objective and innovative assessment methods such as ultrasonography, quantitative sensory test and examination to evaluate symptoms and function.

The evaluation methods used in the study will enable a more in-depth and reliable analysis of symptom management and recovery processes, thereby facilitating the collection of more accurate and reliable data. As there are no similar studies using objective evaluation methods, the methodological contributions of this study will be highly valuable. By offering an innovative approach to pain management and rehabilitation through conservative treatment, it will make significant contributions to both scientific literature and clinical practice.

Enrollment: 48 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Being 18 years of age or older
• Having a diagnosis of mild or moderate CTS confirmed by ENMG
• Having complaints of pain and numbness in the first three fingers of the hand for at least 3 months

Exclusion criteria

• Presence of severe CTS findings on electrophysiological examination
• Presence of metabolic diseases such as uncontrolled diabetes and hypothyroidism
• Presence of inflammatory rheumatic disease (e.g., rheumatoid arthritis)
• Presence of other neuromuscular diseases affecting the hand and wrist (Polyneuropathy, Cervical radiculopathy, peripheral nerve damage, Brachial plexus damage, other entrapment neuropathies, etc.)
• History of hand and wrist trauma
• History of neck and wrist surgery
• History of steroid injection into the carpal tunnel within the last 3 months
• History of physical therapy application to wrist within the last 3 months
• Deformity preventing the use of a splint on the wrist
• Previous participation in a program for the psychological management of chronic pain
• Cognitive dysfunction preventing cooperation with tests

Trial design

Primary purpose: Other

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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48 participants in 2 patient groups

Group 1 (home based exercise program)

Active Comparator group

Description:

Group 1 will receive training on median nerve gliding exercises and self-stretching exercises for the carpal ligament. Patients will be asked to perform 3 sets of median nerve gliding exercises, each consisting of 10 repetitions, and self-stretching exercises for the carpal ligament 3 times a day for 30 seconds as part of home program.

Treatment:

Other: Exercise

Group 2 (home based exercise program and pain neuroscience education)

Experimental group

Description:

Group 2 will receive exercise and pain neuroscience education. The exercise will be taught as a home program, similar to the other group. Pain neuroscience training will be provided twice a week for a total of 6 sessions by a trained physical therapist.

Treatment:

Behavioral: Pain neuroscience education

Other: Exercise