Effectiveness of ultrasound and median nerve gliding with and without shock-wave therapy in patients with moderate carpal tunnel syndrome

Abstract

The aim of this research was to see how ultrasound and nerve gliding with and without shock wave therapy effects on clinical and sonographic data of patients with carpal tunnel syndrome (CTS). [Participants and Methods] Forty four patients with moderate carpal tunnel syndrome participated in this research. One group got shock-wave therapy in addition to median nerve glide exercises and ultrasound, whereas the other group received median nerve glide exercises and ultrasound alone. Hand grip strength (HGS), pinch grip strength (PGS), Visual Analogue Scale (VAS)-pain, Boston Questionnaire (BQ), and Cross-sectional area (CSA) of median nerve were examined before and after 10 sessions of treatment. [Results] HGS, PGS, VAS, BQ and CSA of median nerve improved considerably after therapy. [Conclusion] Patients with moderate CTS who received ultrasound and median nerve glide exercises with and without shock-wave therapy improved considerably without preference of adding shock-wave therapy to other treatment.

The Effects of Radial Extra Corporeal Shock Wave and Low-power Laser Therapies on Clinical and Electrophysiological Parameters in Moderate Carpal Tunnel Syndrome: A Blinded Randomized Control Trial

“…Improvement of function, finger pinch, and hand grip strength was superior in the LPL group in combination with routine treatments compared to routine treatments alone without a significant difference in pain between these two groups. This finding is consistent with systematic reviews and meta-analyses reporting that the efficacy of LPL therapy is similar to routine interventions in improving pain in mild to moderate CTS patients [16,34]. Improving hand function and hand grip and finger pinch strength in the LPL therapy group compared to routine treatment could be attributed to the effect of laser on improving the mitochondrial ATP production and cellular oxygen consumption of the affected hand muscles [16,35].…”

“…This finding is consistent with systematic reviews and meta-analyses reporting that the efficacy of LPL therapy is similar to routine interventions in improving pain in mild to moderate CTS patients [16,34]. Improving hand function and hand grip and finger pinch strength in the LPL therapy group compared to routine treatment could be attributed to the effect of laser on improving the mitochondrial ATP production and cellular oxygen consumption of the affected hand muscles [16,35].…”

“…Then, eligible participants were re-assessed by an electrophysiologist physician to verify CTS. Maximum normal values of distal motor and sensory latency of the median nerve are 4.2 and 3.6 ms, respectively [17,18]. Thus, patients with sensory distal latency of more than 3.6 ms with normal motor latency were categorized as mild CTS.…”

“…Thus, patients with sensory distal latency of more than 3.6 ms with normal motor latency were categorized as mild CTS. However, patients with a sensory distal latency of more than 3.6 ms and motor latency longer than 4.2 were categorized as moderate CTS [17,18]. Subjects were excluded if they had thenar muscles atrophy, lack of sensory and motor responses of median nerve, wrist and hand fractures or operation, cervical radiculopathy, carpal tunnel corticosteroid injection in the last six months, and also pregnant and diabetics and those receiving conservative treatments within two weeks [8,9,19,20].…”

“…Extensive research has investigated the effects of LPL and ESWT alone or with other common treatments in CTS patients with controversial results [1,2,5,10,14,16]. However, there are not many studies comparing the effects of these methods and, also comparing the effects of routine treatments (ultrasound (US), transcutaneous electrical nerve stimulation (TENS), heat, mobilization, and stretching), LPL, and ESWT on the median sensory and motor distal latency and motor nerve conduction velocity (NCV) of the median nerve.…”