Ultrasonographic and electrophysiological outcomes of carpal tunnel syndrome treated with low-level laser therapy: A double-blind, prospective, randomized, sham-controlled study

Abstract

Objectives: The aim of this study was to investigate the therapeutic effects of low-level laser therapy (LLLT) on clinical, ultrasonographic (US), and electrophysiological findings in carpal tunnel syndrome (CTS). Patients and methods: Between January 2015 and August 2015, 42 patients (7 males, 35 females; mean age: 50.4±8.7 years; range, 32 to 65 years) with mild-to-moderate CTS were randomly assigned to one of two groups: active LLLT (therapy group, n=22) 0.8 J/painful point and sham LLLT groups (n=20). Both groups wore neutral wrist orthoses. The patients were evaluated before and after 15 sessions of therapy (670 nm, 4 J/session over the carpal tunnel). Follow-up parameters included the Boston Carpal Tunnel Syndrome Questionnaire (BCTQ) Symptom Severity Scale (SSS), Functional Status Scale (FSS), nerve conduction studies and US evaluation of the median nerve cross-sectional area (CSA), vascularization (via power Doppler), flattening ratio (FR), and palmar bowing of the flexor retinaculum. Results: Nocturnal paresthesia improved in both groups; however, pain and patients with a positive Phalen’s test reduced only in the therapy group (p=0.031). The FSS and SSS scores also improved only in the therapy group (p<0.001). Electrophysiologically, median sensory nerve conduction velocities showed a significant improvement only in the therapy group (p=0.002). The CSA, FR, and vascularization of the median nerve showed a significant improvement in the therapy group alone (p<0.001, p=0.048, and p=0.021, respectively). Conclusion: Improvements in the signs and symptoms of CTS and hand function, the improvements in sensory nerve conduction studies, and reduction in median nerve CSA, FR and vascularity in the LLLT group can be attributed to the anti-inflammatory and analgesic effects of LLLT. This study provides new US data demonstrating efficacy of LLLT along with a clinical and electrophysiological improvement. The LLLT seems to be an easily applied, non-invasive treatment option.

The Effectiveness of Using Laser Therapy on Outcome of Carpal Tunnel Syndrome Patients : A Literature Review

“…[5] The results of DML measurements in the study using laser acupuncture showed better results (DML reduction of 0.03 ms) compared to the placebo group (0.14 DML increase) [15]. However, studies using LLLT showed that the DML score on LLLT (0.22 ms decrease) decreased slightly compared to sham laser therapy (0.46 ms decrease) but was still better than LLLT + Kinesiotaping (0.06 DML decrease) [16]. These results show that the use of LLLT results in a higher reduction in DML than other types of laser therapy.…”

Future Considerations in the Diagnosis and Treatment of Compressive Neuropathies of the Upper Extremity

“…107 , 108 , 109 , 110 More recent literature has examined the effects of LLLT on ultrasound parameters in the treatment of CTS. Nalbant et al 111 performed a randomized sham-controlled study of LLLT and found significant improvements in CSA, flattening ratio, and vascularity of the median nerve as determined by PDUS. Another study by Tezcan et al 112 utilized strain elastography and found that mean values of the strain ratio and CSA of the median nerve decreased after LLLT.…”

The therapeutic potential of carpal tunnel syndrome by laser acupuncture: a before-after interventional study

“…LLLT has the role of enhancing nerve regeneration, increasing axons containing myelin sheaths, and gradually improving motor function in peripheral neuropathies [6]. Numerous clinical trials on CTS show that LLLT reduces symptoms through improved SSS and improves functional recovery through improved FSS, as well as improving electrophysiology on electromyography (EMG) when used monovalent or in combination with other therapies [19,20,21,22]. However, the mixed results indicate that the evidence from the studies is weak, and no clinical data to support the use of LLLT in the treatment of CTS have been discovered [23].…”