Ultrasound and laser therapy in the treatment of carpal tunnel syndrome
Bakhtiary AH, Rashidy-Pour A.
Rehabilitation Faculty, Semnan Medical Sciences University, Senman, Iran. email@example.com.
Aust J Physiother. 2004;50(3):147-51. [PMID: 15482245]
This study was designed to compare the efficacy of ultrasound and laser treatment for mild to moderate idiopathic carpal tunnel syndrome. Ninety hands in 50 consecutive patients with carpal tunnel syndrome confirmed by electromyography were allocated randomly in two experimental groups. One group received ultrasound therapy and the other group received low level laser therapy. Ultrasound treatment (1 MHz, 1.0 W/cm(2), pulse 1:4, 15 min/session) and low level laser therapy (9 joules, 830 nm infrared laser at five points) were applied to the carpal tunnel for 15 daily treatment sessions (5 sessions/week). Measurements were performed before and after treatment and at follow up four weeks later, and included pain assessment by visual analogue scale; electroneurographic measurement (motor and sensory latency, motor and sensory action potential amplitude); and pinch and grip strength. Improvement was significantly more pronounced in the ultrasound group than in low level laser therapy group for motor latency (mean difference 0.8 m/s, 95% CI 0.6 to 1.0), motor action potential amplitude (2.0 mV, 95% CI 0.9 to 3.1), finger pinch strength (6.7 N, 95% CI 5.0 to 8.2), and pain relief (3.1 points on a 10-point scale, 95% CI 2.5 to 3.7). Effects were sustained in the follow-up period. Ultrasound treatment was more effective than laser therapy for treatment of carpal tunnel syndrome. Further study is needed to investigate the combination therapy effects of these treatments in carpal tunnel syndrome patients.
Noninvasive laser neurolysis in carpal tunnel syndrome
Weintraub MI, MD, FACP
The peripheral nervous system is photosensitive providing the scientific rationale for this study, which determines the efficacy and safety of laser light exposure in 30 cases with CTS. Nine joules of energy over five points (7-15 treatments) reversed CTS in 77% of cases with three-fold normalization of CMAP. A photobiologic response was seen in 80% of nerves. This unique and novel approach is cost-effective and will play a role in future management of CTS.
MicroLight Laser – Low-Level Laser Therapy in the Treatment of Carpal Tunnel Syndrome
General Motors Double-Blind Study
Carpal tunnel syndrome treated with a diode laser: a controlled treatment of the transverse carpal ligament
Chang WD, Wu JH, Jiang JA, Yeh CY, Tsai CT.
Department of Bio-Industrial Mechatronics Engineering, National Taiwan University, Taipei, Taiwan.
Photomed Laser Surg. 2008 Dec;26(6):551-7. [PMID: 19025407]
Objective: The purpose of this placebo-controlled study was to investigate the therapeutic effects of the 830-nm diode laser on carpal tunnel syndrome (CTS).
Background data: Many articles in the literature have demonstrated that low-level laser therapy (LLLT) may help to alleviate various types of nerve pain, especially for CTS treatment. We placed an 830-nm laser directly above the transverse carpal ligament, which is between the pisiform and navicular bones of the tested patients, to determine the therapeutic effect of LLLT.
Materials and methods: Thirty-six patients with mild to moderate degree of CTS were randomly divided into two groups. The laser group received laser treatment (10 Hz, 50% duty cycle, 60 mW, 9.7 J/cm(2), at 830 nm), and the placebo group received sham laser treatment. Both groups received treatment for 2 wk consisting of a 10-min laser irradiation session each day, 5 d a week. The therapeutic effects were assessed on symptoms and functional changes, and with nerve conduction studies (NCS), grip strength assessment, and with a visual analogue scale (VAS), soon after treatment and at 2-wk follow-up.
Results: Before treatment, there were no significant differences between the two groups for all assessments (p > 0.05). The VAS scores were significantly lower in the laser group than the placebo group after treatment and at follow-up (p < 0.05). After 2 wk of treatment, no significant differences were found in grip strengths or for symptoms and functional assessments (p > 0.05). However, there were statistically significant differences in these variables at 2-wk follow-up (p < 0.05). Regarding the findings of NCS, there was no statistically significant difference between groups after treatment and at 2-wk follow-up.
Conclusions: LLLT was effective in alleviating pain and symptoms, and in improving functional ability and finger and hand strength for mild and moderate CTS patients with no side effects.