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Meta-Analysis
. 2025 May 20;20(1):491.
doi: 10.1186/s13018-025-05887-w.

Meta-analysis on effects of lymphatic drainage techniques in the management of carpal tunnel syndrome

Sina Shahshenas  1 , Hossein Yarmohammadi  2   3 , Masood Soltanipur  2   3 , Zahra Sheikhi  4   5
Affiliations
Meta-Analysis

Meta-analysis on effects of lymphatic drainage techniques in the management of carpal tunnel syndrome

Sina Shahshenas et al. J Orthop Surg Res. .

Abstract

Background: Carpal tunnel syndrome (CTS) is a common neuropathy caused by median nerve compression, leading to pain, numbness, and functional impairment. While surgical decompression remains the definitive treatment for severe cases, non-surgical approaches are often utilized for symptom management. Lymphatic drainage techniques, including manual lymphatic drainage (MLD) and Kinesio taping, have been proposed as potential therapies for CTS by reducing edema and nerve compression. However, their efficacy remains uncertain. This study aimed to evaluate the effects of lymphatic drainage techniques on symptom severity, functional outcomes, nerve conduction parameters, and pain relief in patients with CTS.

Methods: This meta-analysis was conducted following PRISMA guidelines. A comprehensive search of PubMed, Scopus, and Web of Science databases was performed up to February 2025. Studies assessing the effects of lymphatic drainage techniques (MLD, Kinesio taping, or compression therapy) on CTS-related outcomes were included. Two meta-analytical approaches were used: (1) between-group differences comparing intervention and control groups and (2) within-group changes pre- and post-intervention. Primary outcomes included the Boston Symptom Severity Scale (BSSS), Boston Functional Status Scale (BFSS), Visual Analog Scale (VAS), median nerve cross-sectional area (CSA), hand grip strength, and nerve conduction studies.

Results: Twelve studies met the inclusion criteria, with a total of 479 participants. The between-group meta-analysis revealed significant pain reduction (VAS: SMD = -0.31, 95% CI: -0.51 to -0.12, p < 0.05) and improvements in CSA (SMD = 0.39, 95% CI: 0.10 to 0.68, p < 0.05). Median nerve motor and sensory velocities also improved significantly (p < 0.05). However, BSSS and BFSS did not show significant differences between groups. The within-group analysis demonstrated significant improvements in symptom severity (BSSS: MD = -10.80, 95% CI: -14.73 to -6.78, p < 0.05) and functional status (BFSS: MD = -6.44, 95% CI: -8.78 to -4.09, p < 0.05). The subgroup analysis showed that treatment benefits were sustained over time, with no significant differences between short-term and long-term follow-ups.

Conclusions: Lymphatic drainage techniques offer a promising non-invasive approach for CTS, decreasing pain, reducing edema, and enhancing nerve conduction. While intra-group improvements were notable, limited between-group differences were observed.

Keywords: Carpal tunnel syndrome; Kinesio taping; Lymphatic drainage; Manual lymphatic drainage; Meta-analysis; Nerve conduction; Pain management.

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Conflict of interest statement

Declarations. Ethical approval: Not applicable. Consent to participate: Not applicable. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
PRISMA flow diagram
Fig. 2
Fig. 2
Questionnaires’ outcomes analysis: a) Boston functional status scale difference between groups; b) Boston functional status scale within-group changes; c) Boston symptom severity scale difference between groups; d) Boston symptom severity scale within-group changes; e) Visualize analogue scale difference between groups; f) Visualize analogue scale within-group changes
Fig. 3
Fig. 3
Structural and Functional outcomes analysis: a) Median cross-sectional area difference between groups; b) Median cross-sectional area within-group changes; c) Hand grip difference between groups; d) Hand grip within-group changes
Fig. 4
Fig. 4
Median nerve motor conduction: a) Amplitude difference between groups; b) Amplitude within-group changes; c) Latency difference between groups; d) Latency within-group changes; e) Velocity difference between groups; f) Velocity within-group changes
Fig. 5
Fig. 5
Median nerve sensory conduction: a) Amplitude difference between groups b) Amplitude within-group changes c) Latency difference between groups d) Latency within-group changes e) Velocity difference between groups f) Velocity within-group changes
Fig. 6
Fig. 6
Risk of bias for RCTs and non-randomized trials
See this image and copyright information in PMC

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