Comparison of splinting and splinting plus low-level laser therapy in idiopathic carpal tunnel syndrome

Abstract

This study aimed to compare the short-term efficacy of splinting (S) and splinting plus low-level laser therapy (SLLLT) in mild or moderate idiopathic carpal tunnel syndrome (CTS) with a prospective, randomized controlled study. The patients with unilateral, mild, or moderate idiopathic CTS who experienced symptoms over 3 months were included in the study. The SLLLT group received ten sessions of laser therapy and splinting while S group was given only splints. The patients were evaluated at the baseline and after 3 months of the treatment. Follow-up parameters were nerve conduction study (NCS), Boston Questionnaire (BQ), grip strength, and clinical response criteria. Forty-five patients with CTS completed the study. Twenty-four patients were in S and 21 patients were in SLLLT group. In the third-month control, SLLLT group had significant improvements on both clinical and NCS parameters (median motor nerve distal latency, median sensory nerve conduction velocities, BQ symptom severity scale, and BQ functional capacity scale) while S group had only symptomatic healing (BQ symptom severity scale). The grip strength of splinting group was decreased significantly. According to clinical response criteria, in SLLLT group, five (23.8%) patients had full and 12 (57.1%) had partial recovery; four (19%) patients had no change or worsened. In S group, one patient (4.2%) had full and 17 (70.8%) partial recovery; six (25%) patients had no change or worsened. Additionally, applied laser therapy provided better outcomes on NCS but not in clinical parameters in patients with CTS.

Low-level Laser Treatment Relieves Pain and Neurological Symptoms in Patients with Carpal Tunnel Syndrome

“…This contention is same as that in the past research 17) . Applied to clinical treatments of CTS, LLLT was more effective than other conservative treatments 18,19) . It was apparent based on their results as well as ours, especially for the improvement in symptom severity and neurological signs.…”

“…The velocity of neural conduction also showed statistical significance after the treatment (p<0.05). Some studies found that LLLT performed better than other conservative treatments in reducing neurological signs and nerve conduction velocity 18,19) . Although the effect on neural tissues generated by LLLT is not clear yet, the NCS of CTS were found to be related to the degree of severity of the symptoms in our research.…”

Treatment of the Carpal Tunnel Syndrome with Laser

“…26,27 In a recent prospective, randomized, placebo-controlled trial Evcik, et al reported positive effects on hand and pinch grip strengths after low-level laser therapy. 28 Beneficial effects of the combination of laser therapy with other methods as night orthopedic splint 25 or magnetic stimulation 29 were also reported.…”

Conservative therapeutic management of carpal tunnel syndrome

“…The dose generally used is 8-10 J/cm 2 with a wavelength ranging from 830-904 nm 39 . This low-level laser therapy is applied through a specific probe at different points (usually three) in the wrist where the median nerve travels superficially 40 . The duration of application at each point is 90 seconds 40 .…”

“…This low-level laser therapy is applied through a specific probe at different points (usually three) in the wrist where the median nerve travels superficially 40 . The duration of application at each point is 90 seconds 40 . The purpose of the treatment is to reduce the inflammatory process and edema, but some authors have used the laser as a tool to stimulate points used in acupuncture with the aim of improving associated pain 41 .…”