Forty-three patients with bilateral carpal tunnel syndrome undergoing a unilateral surgical release were randomized in this crossover trial to receive instrument-assisted myofascial mobilization (IASTM) followed by stretching (n=22) or stretching followed by IASTM (n=21) applied bilaterally to both the operated and non-operated hands. Outcomes of interest included hand grip strength, tip pinch gauge, Visual Analog Scale (VAS) pain score, the Boston Carpal Tunnel Questionnaire (BCTQ), and the Short-Form 12 (SF-12) mental and physical components. Outcomes were assessed up to 6 months follow-up. The results found the combination of IASTM and stretching significantly improved all outcomes over time. Treatment effects were larger when applied in the operative hand, and the results indicated that quality of life outcomes and pain relief in non-operated hands were superior when IASTM was applied first.