Sonoelastic response of median nerve to rehabilitation in carpal tunnel syndrome

Abstract

Aim of the study To evaluate the sonoelastic response of the median nerve in patients with carpal tunnel syndrome following conservative rehabilitation with splint plus exercise regimens. Materials and methods A total of thirty-five patients diagnosed with mild carpal tunnel syndrome and treated with splint plus exercise therapy; hand resting splint all day for 3 weeks and then only at nights along with nerve gliding exercises in 10 repetitions 3 times a day. The median nerve was evaluated clinically prior to the treatment and at week 6 of therapy using physical examination, electrodiagnostic neurophysiology tests and radiological imaging; Boston Scores, electromyogram, ultrasonography and sonoelastography. Results Following the 6-week treatment protocol on 35 subjects with mild carpal tunnel syndrome, sonoelastography showed significantly softer median nerve, while the traditional parameters based on Boston Scores and cross-sectional area based on ultrasonography remained nearly unresponsive. Such early indication of biomechanical changes in the nerve may be of clinical importance if it can offer a prognostic value of the applied treatment, while tissue softening suggests the alleviation of nerve compression. Conclusions Sonoelasticity of the median nerve can serve as a reliable marker for assessing therapeutic changes in median nerve stiffness and potentially the outcome early on in mild carpal tunnel syndrome.

Comparison of acupotomy release combined with glucocorticoid intrathecal injection versus isolated glucocorticoid intrathecal injection for carpal tunnel syndrome: A protocol for a meta-analysis of comparative studies

“…[10,11] The vast majority of patients with nonrecalcitrant carpal tunnel syndrome can be treated satisfactorily with conservative rather than surgical treatment. [12][13][14] After adequate rest, functional rehabilitation and oral medication, intrathecal glucocorticoid injection is recommended as the first choice, [15] which can effectively reduce the local inflammatory response and median nerve edema, thus achieving symptomatic relief. [16,17] However, some scholars believe that this can only delay the symptoms in the short-term and cannot solve the problem at the root, because mechanical compression of the median nerve does not achieve relaxation by hormone injection alone.…”