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Combined Physical and Psychological Intervention in Carpal Tunnel Syndrome Patients With Nociplastic Pain
Sponsor: Ahram Canadian University
Summary
This randomized, assessor-blinded, parallel-group trial evaluated the effectiveness of adding a psychologically informed pain-management intervention to standardized physical rehabilitation in adults with electrodiagnostically confirmed carpal tunnel syndrome and coexisting mixed neuropathic-nociplastic pain features. A total of 178 participants were randomized in a 1:1 ratio. The active treatment period lasted 6 weeks, with follow-up through 12 weeks after randomization. The primary outcome was the Boston Carpal Tunnel Questionnaire-Symptom Severity Scale at 6 weeks.
Official title: Effectiveness of a Combined Physical and Psychologically Informed Intervention in Adults With Carpal Tunnel Syndrome and Coexisting Nociplastic Pain Features: A Randomized Controlled Trial
Key Details
Gender
All
Age Range
25 Years - 65 Years
Study Type
INTERVENTIONAL
Enrollment
178
Start Date
2023-07-02
Completion Date
2026-06-22
Last Updated
2026-10-09
Healthy Volunteers
No
Conditions
Interventions
Standardized Carpal Tunnel Syndrome Rehabilitation
Participants will receive a standardized 6-week physical rehabilitation program for carpal tunnel syndrome. Treatment will include night-time neutral-position wrist splinting, flexor-tendon gliding exercises, median-nerve neurodynamic exercises, education regarding activities that provoke symptoms, and a standardized home-exercise program. Supervised physical therapy will be provided twice weekly for 6 weeks, for a total of 12 supervised sessions. Participants will be instructed to perform the prescribed home exercises between supervised sessions.
Psychologically Informed Pain-Management Program
Participants will receive six individual psychologically informed pain-management sessions, approximately 40-45 minutes each, delivered once weekly over 6 weeks. The program will include pain neuroscience education, identification and modification of maladaptive pain beliefs, cognitive restructuring, strategies to reduce pain catastrophizing and fear of movement, graded exposure to feared upper-extremity activities, activity pacing, coping and self-management strategies, and relapse-prevention planning. The intervention will be delivered in addition to standardized CTS rehabilitation.
Attention-Matched Health Education
Participants will receive six individual health-education sessions, approximately 40-45 minutes each, delivered once weekly over 6 weeks. Sessions will be matched approximately to the experimental psychological intervention for therapist contact, frequency, and duration. Content will include general information regarding healthy lifestyle, sleep hygiene, physical activity, and general hand health. The sessions will not include pain neuroscience education, cognitive restructuring, pain-catastrophizing management, graded exposure, or other specific psychologically informed pain-management strategies.
Locations (1)
Outpatient clinic of faculty of physical therapy, Ahram Canadian University
Al Ḩayy Ath Thāmin, Giza Governorate, Egypt