Low-level laser in the treatment of carpal tunnel syndrome: clinical, electrophysiological, and ultrasonographical evaluation.
Summary of "Low-level laser in the treatment of carpal tunnel syndrome: clinical, electrophysiological, and ultrasonographical evaluation."
The objective of this study is to investigate the efficacy of low-level laser therapy (LLLT) in patients with carpal tunnel syndrome (CTS). Sixty patients with CTS were included in this placebo-controlled and double-blind study and randomly assigned to three treatment groups: active laser with a dosage of 1.2 J/per painful point, active laser with a dosage of 0.6 J/per painful point, and placebo groups. A total of 5 points across the median nerve trace were irradiated with Gal-Al-As diode laser. All groups were treated 5 times per week for 3 weeks. Clinical assessments included pain intensity, grip strength, symptom severity score (SSS), functional status score (FSS), nerve conduction studies, and cross-sectional area (CSA) of the median nerve as measured by ultrasonography. Compared to baseline, post-treatment VAS scores (group 1, P < 0.001; group 2, P < 0.001; group 3, P < 0.01), grip strength (P < 0.05), SSS scores (group 1, P < 0.001; group 2, P < 0.001; group 3, P < 0.01), and FSS scores (P < 0.05) improved significantly in all groups. Only sensorial nerve velocity measurements on the palmar region showed a significant improvement in both active laser groups (P < 0.01). There was no significant difference in any of the outcome measures among the groups. With the chosen laser type and dose regimen, the results suggested that LLLT was no more effective than placebo in CTS.
Affiliation
Faculty of Medicine, Department of Physical Therapy and Rehabilitation, Osmangazi University, Meselik Campus, 26480, Eskisehir, Turkey, fundat@ogu.edu.tr.
Journal Details
This article was published in the following journal.
Name: Rheumatology international
ISSN: 1437-160X
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/21120497
- DOI: http://dx.doi.org/10.1007/s00296-010-1652-6
Medical and Biotech [MESH] Definitions
Carpal Tunnel Syndrome
Entrapment of the MEDIAN NERVE in the carpal tunnel, which is formed by the flexor retinaculum and the CARPAL BONES. This syndrome may be associated with repetitive occupational trauma (CUMULATIVE TRAUMA DISORDERS); wrist injuries; AMYLOID NEUROPATHIES; rheumatoid arthritis (see ARTHRITIS, RHEUMATOID); ACROMEGALY; PREGNANCY; and other conditions. Symptoms include burning pain and paresthesias involving the ventral surface of the hand and fingers which may radiate proximally. Impairment of sensation in the distribution of the median nerve and thenar muscle atrophy may occur. (Joynt, Clinical Neurology, 1995, Ch51, p45)
Median Neuropathy
Disease involving the median nerve, from its origin at the BRACHIAL PLEXUS to its termination in the hand. Clinical features include weakness of wrist and finger flexion, forearm pronation, thenar abduction, and loss of sensation over the lateral palm, first three fingers, and radial half of the ring finger. Common sites of injury include the elbow, where the nerve passes through the two heads of the pronator teres muscle (pronator syndrome) and in the carpal tunnel (CARPAL TUNNEL SYNDROME).
Laser Therapy, Low-level
Treatment using irradiation with LASER light of low power intensity so that the effects are not due to heat, as in LASER THERAPY. These non-thermal effects are thought to be mediated by a photochemical reaction that alters CELL MEMBRANE PERMEABILITY, leading to increased mRNA synthesis and CELL PROLIFERATION. Low-level laser therapy has been used for a wide variety of conditions, but most frequently for wound healing and pain control.
Amyloid Neuropathies
Disorders of the peripheral nervous system associated with the deposition of AMYLOID in nerve tissue. Familial, primary (nonfamilial), and secondary forms have been described. Some familial subtypes demonstrate an autosomal dominant pattern of inheritance. Clinical manifestations include sensory loss, mild weakness, autonomic dysfunction, and CARPAL TUNNEL SYNDROME. (Adams et al., Principles of Neurology, 6th ed, p1349)
Angioplasty, Laser
A technique utilizing a laser coupled to a catheter which is used in the dilatation of occluded blood vessels. This includes laser thermal angioplasty where the laser energy heats up a metal tip, and direct laser angioplasty where the laser energy directly ablates the occlusion. One form of the latter approach uses an EXCIMER LASER which creates microscopically precise cuts without thermal injury. When laser angioplasty is performed in combination with balloon angioplasty it is called laser-assisted balloon angioplasty (ANGIOPLASTY, BALLOON, LASER-ASSISTED).
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