Carpal tunnel syndrome (CTS) is a common entrapment neuropathy that causes pain, paresthesia and functional limitations in the hand and wrist. Hydrotherapy methods such as warm whirlpool baths are frequently used in physiotherapy practice to reduce pain and improve soft-tissue properties, but their acute effects on forearm and hand muscle stiffness in CTS have not been clearly quantified.
This randomized controlled trial aims to investigate the acute effects of a single session of warm whirlpool bath therapy on forearm and hand muscle stiffness and pain intensity in adults with CTS. Participants diagnosed with CTS will be randomly allocated to an experimental group receiving a 20-minute warm whirlpool bath or to a resting control group. Muscle stiffness of selected forearm and hand muscles will be assessed using the MyotonPRO device, and pain intensity will be recorded with a numeric rating scale, immediately before and after the intervention. It is hypothesized that warm whirlpool bath therapy will produce a greater reduction in muscle stiffness and pain compared with rest alone.
Being apparently healthy without a known chronic systemic disease
Physically active participants, regardless of gender
Adults aged 18-65 years diagnosed with carpal tunnel syndrome
No history of other chronic musculoskeletal or neurological disorders
Having a previous surgery on the affected wrist or hand
Systemic conditions affecting nerve function, such as diabetes mellitus or thyroid disease
Having a cardiovascular disease or uncontrolled hypertension
Being younger than 18 or older than 65 years
Parallel
Warm Whirlpool Bath Therapy
Procedure/SurgeryThe affected hand and forearm are immersed in a therapeutic whirlpool bath with gently circulating water at approximately 38-39°C for 20 minutes. Participants are positioned to ensure comfort and muscle relaxation. Skin integrity and tolerance to heat are checked before treatment and monitored throughout the session
Resting Control Condition
Other interventionParticipants rest in a comfortable supine or seated position with the affected forearm supported for 20 minutes. No active hydrotherapy, thermal or manual intervention is applied. Positioning and monitoring are comparable to the experimental group.
Primary
Dynamic muscle stiffness (N/m) of selected muscles on the affected upper limb (abductor pollicis brevis, flexor digitorum superficialis, extensor carpi radialis brevis, flexor carpi ulnaris) measured with the MyotonPRO device. For each muscle, three consecutive measurements will be recorded and the mean value will be used for analysis. The primary outcome is the change in stiffness from baseline to post-intervention, compared between the warm whirlpool bath group and the resting control group. Higher values indicate greater muscle stiffness.
Change in Pain Intensity in the Affected Hand/Wrist
Patient-reported pain intensity at the affected hand/wrist assessed using a 0-10 numeric rating scale (0 = no pain, 10 = worst imaginable pain). The primary outcome is the change in pain score from baseline to post-intervention, compared between the warm whirlpool bath group and the resting control group. A decrease in score indicates pain reduction.
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