{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T19:20:23Z","timestamp":1785612023414,"version":"3.56.0"},"reference-count":37,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2017,3,14]],"date-time":"2017-03-14T00:00:00Z","timestamp":1489449600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Health Institute Carlos III","award":["FIS PI14\/00364"],"award-info":[{"award-number":["FIS PI14\/00364"]}]},{"name":"Spanish Government","award":["PN I+D+I 2014-2017"],"award-info":[{"award-number":["PN I+D+I 2014-2017"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["European Journal of Pain"],"published-print":{"date-parts":[[2017,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>People with carpal tunnel syndrome (<jats:styled-content style=\"fixed-case\">CTS<\/jats:styled-content>) exhibit widespread pressure pain and thermal pain hypersensitivity as a manifestation of central sensitization. The aim of our study was to compare the effectiveness of manual therapy versus surgery for improving pain and nociceptive gain processing in people with <jats:styled-content style=\"fixed-case\">CTS<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The trial was conducted at a local regional Hospital in Madrid, Spain from August 2014 to February 2015. In this randomized parallel\u2010group, blinded, clinical trial, 100 women with <jats:styled-content style=\"fixed-case\">CTS<\/jats:styled-content> were randomly allocated to either manual therapy (<jats:italic>n<\/jats:italic>\u00a0=\u00a050), who received three sessions (once\/week) of manual therapies including desensitization manoeuvres of the central nervous system, or surgical intervention (<jats:italic>n<\/jats:italic>\u00a0=\u00a050) group. Outcomes including pressure pain thresholds (<jats:styled-content style=\"fixed-case\">PPT<\/jats:styled-content>), thermal pain thresholds (<jats:styled-content style=\"fixed-case\">HPT<\/jats:styled-content> or <jats:styled-content style=\"fixed-case\">CPT<\/jats:styled-content>), and pain intensity which were assessed at baseline, and 3, 6, 9 and 12\u00a0months after the intervention by an assessor unaware of group assignment. Analysis was by intention to treat with mixed <jats:styled-content style=\"fixed-case\">ANCOVA<\/jats:styled-content>s adjusted for baseline scores.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>At 12\u00a0months, 95 women completed the follow\u2010up. Patients receiving manual therapy exhibited higher increases in <jats:styled-content style=\"fixed-case\">PPT<\/jats:styled-content> over the carpal tunnel at 3, 6 and 9\u00a0months (all, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.01) and higher decrease of pain intensity at 3\u00a0month follow\u2010up (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001) than those receiving surgery. No significant differences were observed between groups for the remaining outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Manual therapy and surgery have similar effects on decreasing widespread pressure pain sensitivity and pain intensity in women with <jats:styled-content style=\"fixed-case\">CTS<\/jats:styled-content>. Neither manual therapy nor surgery resulted in changes in thermal pain sensitivity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p>The current study found that manual therapy and surgery exhibited similar effects on decreasing widespread pressure pain sensitivity and pain intensity in women with carpal tunnel syndrome at medium\u2010 and long\u2010term follow\u2010ups investigating changes in nociceptive gain processing after treatment in carpal tunnel syndrome.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ejp.1026","type":"journal-article","created":{"date-parts":[[2017,3,14]],"date-time":"2017-03-14T21:18:44Z","timestamp":1489526324000},"page":"1266-1276","source":"Crossref","is-referenced-by-count":27,"title":["Effectiveness of manual therapy versus surgery in pain processing due to carpal tunnel syndrome: A randomized clinical trial"],"prefix":"10.1002","volume":"21","author":[{"given":"C.","family":"Fern\u00e1ndez\u2010de\u2010las\u2010Pe\u00f1as","sequence":"first","affiliation":[{"name":"Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine Universidad Rey Juan Carlos Alcorc\u00f3n Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Cleland","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy Franklin Pierce University Manchester USA"},{"name":"Rehabilitation Services Concord Hospital USA"},{"name":"Manual Therapy Fellowship Program Regis University Denver USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Palacios\u2010Ce\u00f1a","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine Universidad Rey Juan Carlos Alcorc\u00f3n 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