Effect of Laser Therapy, Neurodynamic Stabilization and Strengthening Exercises on Hand Function in Patients of Carpal Tunnel Syndrome with Rheumatoid Arthritis- A Narrative Review

Background: Carpal tunnel syndrome (CTS) is an entrapment neuropathy in which median nerve is compressed or squeezed at the wrist level in the carpal tunnel. Carpal tunnel syndrome is the most prevalent neurological complication in the rheumatoid arthritis patients. The prevalence of CTS in RA ranged from 3.5% to 22.8 %. Tenosynovitis, inflammation of the synovial tissue of the flexor tendons, can cause increased pressure in the carpal tunnel and result in CTS. Hand function is usually affected in carpel tunnel syndrome which affects the daily living performance by affecting both gross motor activities like grasping, carrying, holding and fine motor activities like writing, gripping and buttoning the shirts. Laser therapy, also called as photo biomodulation, can reduce pain, inflammation, swelling and synovitis. The dexterity and functionality of the hands improved through hand and wrist stretching and strengthening exercises. Objective: To find out the effect of laser therapy, neurodynamic mobilization exercises and strengthening exercises on hand function in patients of carpal tunnel syndrome with rheumatoid arthritis. Study selection: This narrative review is conducted on databases from Pubmed, Google scholar, scopus, web of knowledge, Virtual Health Library, Research Gate and Cochrane library in Nov 2023.