The effectiveness of gabapentin and exercises in the treatment of carpal tunnel syndrome: a randomized clinical trial

Hesami, Omid; Haghighatzadeh, Mahsa; Lima, Behnam Safarpour; Emadi, Naghmeh; Salehi, Shahin

doi:10.12965/jer.1836420.210

Cited by 12 publications

(9 citation statements)

References 27 publications

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“…This difference could be related to the diversity in intervention methods, some acupuncture sessions and the primary characteristics of patients. In Hessami et al study showed that the use of splint alone in mild CTS is a suitable and adequate treatment; however, in moderate CTS, taking gabapentin along with splinting and exercise indicated better treatment results compared to splinting alone (49). The current study found that nerve and tendon gliding exercises can improve grip and pinch strength which is consistent with Pinar et al results (23).…”

Section: Discussionsupporting

confidence: 87%

The Effectiveness of Exercise Therapy and Dry Needling on Wrist Range of Motion, Pinch and Grip Force in Carpal Tunnel Syndrome: A Randomized Clinical Trial

et al. 2020

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Background: Carpal tunnel syndrome (CTS) is the most prevalent form of peripheral neuropathy. There are various treatments for carpal tunnel. Objectives: In this study, we evaluated the effect of electroacupuncture and exercise on pinch and grip strength and wrist range of motion in patients with mild to moderate CTS. Methods: Sixty patients with carpal tunnel syndrome were evaluated in this study, only five of whom were male. In this study, patients were divided into three groups. The control group consisted of 20 patients who only used splints in the second group, in addition to splints, special exercises were administered, and the third group, electroacupuncture, and brace were prescribed for 12 sessions of 40-minute duration. study time was 6 weeks. The parameters of pinch force, grip force, ROM (flexion and extension) were evaluated at baseline and after the treatment. Results: In this study, 55 women and 5 men with an average age of 49.23 ± 8.96 were enrolled. At the final follow up, significant improvements in all parameters were found in third groups (P < 0.05), except flexion of the wrist in the control group (P = 0.098). Our findings indicate that exercise therapy had more effect on ROM of flexion than acupuncture and acupuncture had more effect on pinching than exercise therapy but the effect sizes were weak. Also, the efficacy of splint alone was less than intervention groups in all parameters. Conclusions: Results of this study demonstrated that adding exercise or acupuncture to nocturnal splinting, the functional improvement is more in patients with mild to moderate carpal tunnel syndrome and these interventions could be adopted in the management of these patients.

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Section: Discussionsupporting

confidence: 87%

The Effectiveness of Exercise Therapy and Dry Needling on Wrist Range of Motion, Pinch and Grip Force in Carpal Tunnel Syndrome: A Randomized Clinical Trial

et al. 2020

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“…Recently, several clinical trials have suggested the efficacy of GABA use for off-label pain conditions (e.g. chronic sciatica; irritable bowel syndrome) and for reducing acute and chronic postoperative pain and OPI use [50][51][52][53][54][55]. However, given the safety concerns about GABAs, there have been calls for placing more stringent regulations on gabapentin at the federal level and to include gabapentin monitoring in state prescription drug monitoring programs (PDMPs) to promote safety.…”

Section: Discussionmentioning

confidence: 99%

Dual‐trajectories of opioid and gabapentinoid use and risk of subsequent drug overdose among Medicare beneficiaries in the United States: a retrospective cohort study

et al. 2020

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Background and aims Little is known about opioid and gabapentinoid (OPI‐GABA) use duration and dose patterns’ associations with adverse outcome risks. We examined associations between OPI‐GABA dose and duration trajectories and subsequent drug overdose. Design Retrospective cohort study. Setting US Medicare. Participants Using a 5% sample (2011–16), we identified 71 005 fee‐for‐service Medicare beneficiaries with fibromyalgia, low back pain, neuropathy and/or osteoarthritis initiating OPIs and/or GABAs [mean age ± standard deviation (SD) = 65.5 ± 14.5 years, female = 68.1%, white = 76.8%]. Measurements Group‐based multi‐trajectory models identified distinct OPI‐GABA use patterns during the year of OPI and/or GABA initiation, based on weekly average standardized daily dose (i.e. OPIs = morphine milligram equivalent, GABAs = minimum effective daily dose). We estimated models with three to 12 trajectories and selected the best model based on Bayesian information criterion (BIC) and Nagin's criteria. We estimated risk of time to first drug overdose diagnosis within 12 months following the index year, adjusting for socio‐demographic and health factors using inverse probability of treatment weighted multivariable Cox proportional hazards models. Findings We identified 10 distinct trajectories (BIC = –1 176 954; OPI‐only = 3, GABA‐only = 3, OPI‐GABA = 4). Compared with OPI‐only early discontinuers (40.6% of the cohort), 1‐year drug overdose risk varied by trajectory group: consistent low‐dose OPI‐only users [16.6%; hazard ratio (HR) = 1.47, 95% confidence interval (CI) = 1.19–1.82], consistent high‐dose OPI‐only users (1.8%; HR = 4.57, 95% CI = 2.99–6.98), GABA‐only early discontinuers (12.5%; HR = 1.39, 95% CI = 1.09–1.77), consistent low‐dose GABA‐only users (11.0%; HR = 1.44, 95% CI = 1.12–1.85), consistent high‐dose GABA‐only users (3.1%; HR = 1.43, 95% CI = 0.94–2.17), early discontinuation of OPIs and consistent low‐dose GABA users (6.9%; HR = 1.24, 95% CI = 0.90–1.69), consistent low‐dose OPI‐GABA users (3.4%; HR = 2.49, 95% CI = 1.76–3.52), consistent low‐dose OPI and high‐dose GABA users (3.2%; HR = 2.46, 95% CI = 1.71–3.53) and consistent high‐dose OPI and moderate‐dose GABA users (0.9%; HR = 7.22, 95% CI = 4.46–11.69). Conclusions Risk of drug overdose varied substantially among US Medicare beneficiaries on different use trajectories of opioids and gabapentinoids. High‐dose opioid‐only users and all consistent opioid and gabapentinoid users (regardless of doses) had more than double the risk of subsequent drug overdose compared with opioid‐only early discontinuers.

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“…Hesami et al researched a study in 2018 on the treatment of carpal tunnel syndrome and gabapentin [ 40 ]. The cases were divided into four groups with different combinations of nocturnal splint, exercise and gabapentin.…”

Section: Discussionmentioning

confidence: 99%

Residual Symptoms After Carpal Tunnel Decompression and Treatment With Gabapentin: A Multicenter Study

Aydın

Argun²,

Acar

et al. 2021

Cureus

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Objectives To identify postoperative residual symptoms of carpal tunnel syndrome (CTS) and to investigate the effectiveness of gabapentin in the treatment of residual symptoms. Materials and methods Of a total of 412 patients who underwent surgery for CTS in four centers over a four-year period, 14 who had residual symptoms after CTS release and did not receive gabapentin (Group A) and 14 patients with postoperative residual symptoms and received gabapentin were included in this retrospective study. Postoperative residual symptoms were defined as persistent nocturnal numbness and tingling with or without occasional daytime pain. Tinel’s and Phalen’s tests were performed for the diagnosis of residual symptoms. Functional Severity Score (FSS), Symptom Severity Score (SSS), and Visual Analog Scale (VAS) were used to evaluate functional outcomes, severity of symptoms, and numbness and sleep quality, respectively at six and 12 weeks postoperatively. Level of Evidence: III, therapeutic study Results There was no statistically significant difference in the mean postoperative FSS (p=0.845) and VAS-numbness scores (p=0.367) between the groups. However, there was a statistically significant difference in the mean postoperative SSS (p=0.025) and VAS-sleep quality scores (p<0.001) between the groups. Conclusion Gabapentin treatment can be a treatment of choice for residual symptoms after CTS surgery and clinical improvement can be achieved owing to its relieving effect, particularly in nocturnal symptoms of patients having neuropathic pain.

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The effectiveness of gabapentin and exercises in the treatment of carpal tunnel syndrome: a randomized clinical trial

Cited by 12 publications

References 27 publications

The Effectiveness of Exercise Therapy and Dry Needling on Wrist Range of Motion, Pinch and Grip Force in Carpal Tunnel Syndrome: A Randomized Clinical Trial

The Effectiveness of Exercise Therapy and Dry Needling on Wrist Range of Motion, Pinch and Grip Force in Carpal Tunnel Syndrome: A Randomized Clinical Trial

Dual‐trajectories of opioid and gabapentinoid use and risk of subsequent drug overdose among Medicare beneficiaries in the United States: a retrospective cohort study

Residual Symptoms After Carpal Tunnel Decompression and Treatment With Gabapentin: A Multicenter Study

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