Comparative Effectiveness of Low Level Laser Therapy and Nerve Gliding Exercises on Patients with Carpal Tunnel Syndrome: a Randomized Clinical Trial Wanees M. Badawy Department of Physical Therapy for Neuromuscular Disorder and its Surgery, Faculty of Physical Therapy, Cairo University, Egypt. Abstract : Background and purpose: There is lack of definite evidence indicating an effective treatment for carpal tunnel syndrome (CTS). Low level laser therapy (LLLT) has long been used as one of the conservative treatments for CTS. On contrast, nerve gliding exercises have been introduced recently as a physical modality in treating patients with entrapment neuropathies. The purpse of this study was to compare the effectiveness of combining a wrist splint with either LLLT or nerve gliding exercises in treating CTS patients. Methods: 35 patients with mild to moderate CTS were randomized into two groups. Group(I) (18 patients underwent LLLT, and group (II) (17 patients) underwent nerve gliding exercises. All patients received a neutral wrist splint. Outcome measures included visual analogue scale (VAS); hand grip and pinch strength; sensory examiniation; Boston carpal tunnel syndrome questionnaire before and after treatment for xix weeks. Results : Statistical analysis revealed significant improvements in VAS, handgrip and pinch strength, and symptom severity and functional status scores after treatment as compared to group (II). Conclusions: The combination of LLLT with a wrist splint may be more effective than nerve gliding exercises with a wrist splint. Keywords : Carpal tunnel syndrome, low level laser therapy, nerve gliding exercise. Introduction Carpal tunnel syndrome (CTS) is a peripheral neuropathy at the level of the wrist caused by compression of the median nerve within the carpal tunnel. The classical symptoms involve pain, numbness, tingling, burning, and paresthesia in the distribution of the median nerve (i.e., the thumb and the index and middle fingers) and the thenar muscle may experience atrophy 1 . Diagnosis of CTS is centered on major triads; the patient history, specific physical examination (i.e. Phalen test), and nerve conduction studies. Women are three times more affected than men in their fourth to seventh decade 2 , presented with painful numbness at the median nerve course in hand and often relieved if the hand is shaked repetitively (Flick’s sign) 3 . Patients with mild to moderate symptoms are treated conservatively using oral medication, local steroid injection, ultrasound therapy (UST), and paraffin bath, low-level laser therapy (LLLT), wrist splinting, therapeutic exercise 4,5 . Conversely, ultimate evidence on the best modality for treating patients with CTS is missing. International Journal of ChemTech Research CODEN (USA): IJCRGG, ISSN: 0974-4290, ISSN(Online):2455-9555 Vol.10 No.2, pp 462-467, 2017