Abstract
Objective: The purpose of this study was to increase the awareness of physical therapy in management of Carpal Tunnel Syndrome amongst the clients and clinicians. Methods: A case was selected from an outpatient department in Ayub Medical Complex Abbottabad. A 45 years old house wife had presentation with pain in the right wrist along with numbness and paresthesia in hand radiating to left thumb, index and middle finger. Pain level reported on verbal numeric scale was 8/10 (0 to 10) and affected the client’s ADL’s & IADL’s. A Nerve conduction study was done earlier which showed the slowing of nerve conduction over the right wrist. X-rays of cervical spine were done to exclude cervical radiculopathy before the physical therapy started during treatment medicine intake was stopped.
Results: The subject received six consecutive sessions of 40 minutes in duration, 3 times per week for two week, during each session, the manual mobilization of flexor retinaculum and intercarpal joints along with Infrared Radiation greatly improved the symptoms of CT. Strengthening exercises and education about the positional of hand movements at home was also administered. Before this treatment was commenced, Client was taking Artifen 300/day (diclofenic sodium) for pain management and for numbness and paresthesia; no change in the symptom had been reported. After the 6th session of physical therapy and proper follow up of the home exercise program, client reported being pain free on numerical scale 0 to 10 with no radiation of pain to hand along with pain free ADL’s and IADL’s.
Conclusion; This study shows the manual mobilization technique, Infra red rays, strengthening exercises of the right hand and client awareness about positional patterns of the hand greatly improved the symptoms of CTS. To find the evidence for a specific treatment strategy needs more comprehensive studies to be done such as RCTs.

Key words: Transverse carpal ligament, Carpal tunnel syndrome and friction massage. Transverse carpal ligament, Carpal tunnel syndrome and friction massage. Transverse carpal ligament, Carpal tunnel syndrome and friction massage