Use of Iontophoresis with Corticosteroid in Carpal Tunnel Syndrome: Systematic Review and Meta-Analysis

Abstract

Background: Carpal tunnel syndrome is a neuropathy that affects the median nerve. The aim of this review is to synthesize the evidence and perform a meta-analysis on the effects of iontophoresis in people with carpal tunnel syndrome. Methods: The search was carried out using PubMed, Web of Science, Scopus, CINHAL Complete, Physiotherapy Evidence Database, and SciELO. The methodological quality was evaluated using PEDro. A standardized or mean difference meta-analysis (Hedge’s g) using a random-effects model was calculated. Results: Seven randomized clinical trials using iontophoresis for electrophysiological, pain, and functional outcomes were included. The mean of PEDro was 7/10. No statistical differences were obtained for the median sensory nerve conduction velocity (SMD = −0.89; p = 0.27) or latency (SMD = −0.04; p = 0.81), motor nerve conduction velocity (SMD = −0.04; p = 0.88) or latency (SMD = −0.01; p = 0.78), pain intensity (MD = 0.34; p = 0.59), handgrip strength (MD = −0.97; p = 0.09), or pinch strength (SMD = −2.05; p = 0.06). Iontophoresis only seemed to be superior in sensory amplitude (SMD = 0.53; p = 0.01). Conclusions: Iontophoresis did not obtain an enhanced improvement compared to other interventions, but no clear recommendations could be made due to the limited number of included studies and the heterogeneity found in the assessment and intervention protocols. Further research is needed to draw sound conclusions.

Long-Term Outcomes of Non-surgical versus Surgical Treatment for Carpal Tunnel Syndrome: An Observational Cohort Study

“…(9) According to Jones and Brown (2022), CTR has a high success rate, with most patients reporting significant long-term symptom relief (10) However, as highlighted by Davis and Lee (2023), surgical interventions are not without risks, including complications and a longer recovery period compared to non-surgical methods (11) Recent studies have begun to explore patient-specific factors that might predict the success of either treatment. For instance, a cohort study by Martin et al (2022) found that age and severity of symptoms play a significant role in determining the long-term outcomes of CTS treatments (12) In conclusion, while both non-surgical and surgical treatments for CTS can be effective, their long-term outcomes vary. Surgical treatment appears to provide more lasting relief for severe cases, but it carries a higher risk and recovery burden.…”

Evaluating The Effect Of Pregabalin In The Treatment Of Carpal Tunnel Syndrome

“…Nonsurgical treatment includes splinting 4 at the neutral position, physical therapy, 5,6 nonsteroidal anti-inflammatory drugs (NSAIDs), local steroid injection, 7 and ergonomic modification. Physical therapy 8,9 for CTS includes manual therapy (sliding and tensioning techniques) based on neurodynamic techniques or electrophysical modalities (laser therapy, 10 therapeutic ultrasound, 11 extracorporeal shock wave therapy, 12 repetitive peripheral magnetic stimulation, 13 and iontophoresis 14 ). Novel therapies like local ozone injection, 15 5% dextrose water injection, 16 and platelet-rich-plasma injection 17 into the carpal tunnel have also been proposed.…”