DRY NEEDLING AND NEURAL MOBILIZATION TECHNIQUES IN RADIAL TUNNEL SYNDROME: A RANDOMIZED CONTROLLED TRIAL

Abstract

Background: Radial nerve entrapment is a common peripheral neuropathy that leads to pain, muscle weakness, and functional impairment. Various conservative treatments, including dry needling and peripheral neural mobilization, have been explored for symptom management. However, limited evidence exists regarding the combined efficacy of these interventions in improving pain, grip strength, and functional disability. Establishing an effective rehabilitation approach could enhance patient outcomes and optimize treatment strategies for radial nerve entrapment syndrome.

Objective: To compare the effects of dry needling combined with neural mobilization versus dry needling alone on pain, grip strength, and disability in patients with radial nerve entrapment syndrome.

Methods: A randomized controlled trial was conducted with 34 participants diagnosed with radial nerve entrapment. Participants were randomly assigned to either an experimental group receiving dry needling combined with peripheral neural mobilization (n = 17) or a control group receiving dry needling alone (n = 17). Outcome measures included the Numeric Pain Rating Scale (NPRS) for pain, a handheld dynamometer for grip strength, and QuickDASH for disability. NPRS was analyzed using the Wilcoxon Signed Rank Test due to non-normal distribution, while repeated measures ANOVA was applied for grip strength and QuickDASH scores. Assessments were conducted at baseline and after four weeks of intervention.

Results: The experimental group demonstrated a significant reduction in pain (NPRS: 7.00 ± 1.22 to 3.00 ± 1.41, p < 0.05), greater improvement in grip strength (19.18 ± 6.78 kg to 33.35 ± 4.04 kg, p < 0.05), and a substantial decrease in disability (QuickDASH: 76.06 ± 5.08 to 44.11 ± 9.84, p < 0.05). In contrast, the control group exhibited less significant changes in pain (NPRS: 7.00 ± 1.13 to 5.00 ± 1.34, p > 0.05), grip strength (17.53 ± 6.26 kg to 27.52 ± 6.26 kg, p > 0.05), and disability (QuickDASH: 80.34 ± 6.42 to 73.26 ± 6.50, p > 0.05).

Conclusion: Dry needling is effective in managing pain and functional impairment in radial nerve entrapment syndrome, but its combination with peripheral neural mobilization yields superior outcomes in pain relief, grip strength enhancement, and functional recovery. These findings suggest that integrating neural mobilization with dry needling should be considered as a preferred rehabilitation strategy for optimizing treatment efficacy in patients with radial nerve entrapment.