Comparison of the Short-Term Effectiveness of Short-Wave Diathermy Treatment in Patients With Carpal Tunnel Syndrome: A Randomized Controlled Trial

Abstract

Carpal tunnel syndrome (CTS) is one of the most common entrapment neuropathies caused by compression of the median nerve within the carpal tunnel in the wrist. 1 The diagnosis is based on medical history, clinical and physical examination findings, as well as electrophysiological confirmation. Available conservative treatments include wrist-resting splints, local steroid injections, non-steroidal antiinflammatory drugs (NSAIDs), physical therapy, diuretics, vitamin B6, and activity modification. However, the efficacy of these treatments remains controversial. 2,3Short-wave diathermy (SWD) is a form of electromagnetic therapy used at a frequency of 27.12 MHz in continuous or pulsed forms. Molecular distortion occurs due to the movement of ions in the electromagnetic field, and heat is generated in the deep tissues with induced eddy currents. 4 In addition to the effects of SWD on the tissues, healing is stimulated with increased vascular circulation and pain threshold, and decreased pain and chronic inflammation. 5 It is thought that these effects cannot be explained solely by the heating effect, and some of the therapeutic effects of SWD treatment Objectives: This study aims to compare the effects of pulsed and continuous short wave diathermy (SWD) treatment in carpal tunnel syndrome. Patients and methods: This double-blind, randomized controlled trial included 30 patients (55 wrists) diagnosed with mild or moderate carpal tunnel syndrome. Patients were randomized into three groups and administered splinting and one of the following treatments: group 1: continuous SWD, group 2: pulsed SWD, and group 3: placebo SWD. The treatment was applied five days a week for 15 sessions. Patients were evaluated by the Tinel's test, Phalen's and reverse Phalen's maneuvers, carpal compression test, the Boston Carpal Tunnel Questionnaire (BCTQ: includes 2 parts, namely the symptom severity scale and functional status scale), and a visual analog scale. Median motor distal latency, median sensory distal latency, and nerve conduction velocity were measured. Electrophysiological findings, clinical tests, and scales were evaluated at the beginning and end of the therapy. Results: A significant difference was observed in Phalen's maneuver positivity in the pulsed SWD group (p<0.05). Visual analog scale, BCTQfunctional status scale, BCTQ-symptom severity scale, median nerve motor and sensory latencies, and sensory nerve conduction velocity values were improved in both continuous and pulsed SWD groups (p<0.05). The placebo group also showed improved BCTQ-functional status scale and median nerve motor distal latency (p<0.05). BCTQ-symptom severity scale improved more in the continuous SWD group than the other groups (p<0.01), and improved median nerve sensory distal latency and nerve conduction velocity parameters were observed in both SWD groups than the control group (p<0.01). Conclusion: Continuous and pulsed SWD therapies supported with splinting were effective for improving pain, hand function, and electrophysiological findings. In ...

Radiofrequency-based treatment in therapy-related clinical practice – a narrative review. Part II: chronic conditions

“…Further, one clinical trial each on TMJ pain, 100 trigger point pain 101 and myofascial pain; 102 and one case study each on Herpes Zoster pain, 103 heel neuroma, 104 avascular necrosis of the femoral head, 105 and multiple cases of pain 106 were also identified. Two recently published clinical trials 39,107 on carpal tunnel syndrome were also included.…”

“…In two recently published studies, 39,107 both CSWT and PSWT (15 sessions in 3 weeks, 20 minutes per session) were reported to be effective in the management of mild and moderate carpal tunnel syndrome (CTS) compared to a placebo. Significant improvements were gained in pain, hand function and the electrophysiological measurements.…”

Effectiveness of electrophysical modalities in the sensorimotor rehabilitation of radial, ulnar, and median neuropathies: A meta-analysis

“…We identified possible performance and detection biases in several studies associated with allocation concealment [ 37 , 39 , 43 , 44 , 47 , 50 , 51 , 53 , 55 – 57 , 63 , 67 , 68 ], blinding of participants [ 37 , 41 – 43 , 46 , 47 , 50 – 52 , 55 – 57 , 62 , 66 – 70 ], blinding of personnel [ 37 , 38 , 41 – 47 , 50 – 53 , 55 – 57 , 60 , 62 , 63 , 66 – 68 , 70 , 71 ], blinding of outcome assessors [ 39 , 42 – 44 , 46 , 49 , 55 , 58 , 60 , 67 ] that was unclear or not provided. As well as attrition [ 36 , 37 , 39 , 40 ,…”

“…We identified possible performance and detection biases in several studies associated with allocation concealment [37,39,43,44,47,50,51,53,[55][56][57]63,67,68], blinding of participants [37,[41][42][43]46,47,[50][51][52][55][56][57]62,[66][67][68][69][70], blinding of personnel [37,38,[41][42][43][44][45][46][47][50][51][52][53][55][56][57]60,62,63,…”

Carpal tunnel syndrome

“…U novijoj studiji Boyaci i sur. 58 proučavali su učinke pulsirajućeg KD-a u usporedbi s kontinuiranim KD-om i placebom. Svakoj skupini aplicirano je 20 minuta KD-a dnevno, 5 dana u tjednu, tijekom 3 tjedna.…”