Hi, sorry, I did not think anyone had taken an interest in this case study, so I neglected to update you on the situation.

I saw the patient last thurs (now sat night) and there was very little change. She reported that she had more mvt, but this was not objectively the case.

Her wrist mvt is very much dependant on neural tension, and is therefore severely limited (10-20 degrees painless mvt) with extended fingers, but moderately more with flexed fingers.

She also reports that the Rx from the previous session (see above) seemed to cause some aggrevation for the rest of the day (as i expected, and as I warned). Unfortunately, she did not try ice therapy because "it was already too painful" and she didnt want to try anything that would make it worse. (I think she then associated physio Rx and advice with pain, unfortunately..) Further to this, she had been performing the massage at home and reported that it was painful for the rest of the day.. When asked for how she was performing the massage, she replied "about an hour".. And with further probing she reported that it became painful after approx 10 mins of massage.
Obviously I take responsibility for this as I must have neglected to prescribe set parameters for the massage...

As a note of interest it also came up that she was driving with this hand, which, considering the lack of RoM and associated pain, is quite scary. Obviously I advised against this, but there is only so much you can do...

During the session she was very reluctant to allow any massage out of fear of pain. After some discussion we agreed that a possible route may be electrotherapy (even though I am not a huge advocate), so we tried a short session of Short Wave Diathermy.

After approx 5 mins of Rx she reported that the "ache" had reduced, and had now been replaced by a tingling sensation. She reported this as a positive change.

As a home exercise I prescribed the same active mvts within painless range and just 2 mins of massage twice daily to the anterior wrist area and thenar eminence.

Thank you for your interest and advice. Ginger, from the behaviour of the symptoms I would be surprised if it were originating from the Cx/TxSp, but it maybe worth a look!

Alophysio, i have assumed the same thing (re. results of nerve conduction tests), and for the moment that is all I can do. As far as I'm aware there has been no CxSp assessment done so far, but I will make sure to do one next time. She did not report any previous physio...
Is neural mobilisation the same as "neural flushing" - i.e. smooth rythmic mvts to run the neural system through its various sleaves, (etc.)?