Efficiency of Direct Transcutaneous Electroneurostimulation of the Median Nerve in the Regression of Residual Neurological Symptoms after Carpal Tunnel Decompression Surgery

Abstract

Carpal tunnel syndrome (CTS) is the most frequent entrapment neuropathy. CTS therapy includes wrist immobilization, kinesiotherapy, non-steroidal anti-inflammatory drugs, carpal tunnel steroid injection, acupuncture, and physical therapy. Carpal tunnel decompression surgery (CTDS) is recommended after failure of conservative therapy. In many cases, neurological disorders continue despite CTDS. The aim of this study was to investigate the efficiency of direct transcutaneous electroneurostimulation (TENS) of the median nerve in the regression of residual neurological symptoms after CTDS. Material and Methods: 60 patients aged 28–62 years with persisting sensory and motor disorders after CTDS were studied; 15 patients received sham stimulation with a duration 30 min.; 15 patients received high-frequency low-amplitude TENS (HF TENS) with a duration 30 min; 15 patients received low-frequency high-amplitude TENS (LF TENS) with a duration 30 min; and 15 patients received a co-administration of HF TENS (with a duration of15 min) and LF TENS (with a duration of 15 min). Results: Our research showed that TENS significantly decreased the pain syndrome, sensory disorders, and motor deficits in the patients after CTDS. Predominantly, negative and positive sensory symptoms and the pain syndrome improved after the HF TENS course. Motor deficits, reduction of fine motor skill performance, electromyography changes, and affective responses to chronic pain syndrome regressed significantly after the LF TENS course. Co-administration of HF TENS and LF TENS was significantly more effective than use of sham stimulation, HF TENS, or LF TENS in patients with residual neurological symptoms after CTDS.

Comparative Analysis of High-Frequency and Low-Frequency Transcutaneous Electrical Stimulation of the Right Median Nerve in the Regression of Clinical and Neurophysiological Manifestations of Generalized Anxiety Disorder

“…Following TENS, there was a decrease in BOLD signal in limbic brain regions, including the amygdala, hippocampus, parahippocampal gyrus, middle, and superior temporal gyrus, which was accompanied by increased activation of the insula, precentral gyrus, and thalamus [75,76]. The anxiolytic effect of TENS has been found in the treatment of patients with insomnia [77,78], distal polyneuropathy [27], carpal tunnel syndrome [26], post-traumatic stress disorder [79], post-hemorrhoidectomy syndrome [80], in preoperative anxiolytic preparation before thoracoscopic surgery [81], during induction of labor [44], and dental procedures [82]. However, in rare studies, TENS has been successfully used in the treatment of GAD [29].…”

“…Transcutaneous electrical nerve stimulation (TENS) has analgesic, restorative, and regenerative effects [26][27][28]. However, the anxiolytic effect of TENS has not been well studied [29].…”

“…However, the anxiolytic effect of TENS has not been well studied [29]. Nonetheless, several studies have been published demonstrating the effectiveness of TENS in the treatment of anxiety disorders during and after the procedure [26,28,30,31].…”

Functional Recovery and Regenerative Effects of Direct Transcutaneous Electrical Nerve Stimulation in Treatment of Post-COVID-19 Guillain–Barré and Acute Transverse Myelitis Overlap Syndrome: A Clinical Case

“…TENS was originally intended for the treatment of pain [ 17 ]. Gradually, the effectiveness of TENS in accelerating regenerative processes and reducing neurological deficits has been proven in many clinical and experimental studies [ 18 , 19 , 20 , 21 , 22 ].…”