Low-level laser therapy for carpal tunnel syndrome: systematic review and network meta-analysis

Cheung, Wai W.; Wu, Irene Xin Yin; Sit, Regina W.S.; Ho, Robin S.T.; Wong, Charlene H.L.; Chung, Vincent CH

doi:10.1016/j.physio.2019.06.005

Cited by 21 publications

(14 citation statements)

References 35 publications

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“…The researchers concluded that LA treatment was more effective than placebo LA treatment in CTS in terms of symptom intensity. The same results were obtained by Cheung et al [18] , who conducted a systematic review to study the advantages and disadvantages of LLLT over placebo therapy and other conservative CTS treatments. The results showed that there was no evidence that LLLT was more effective than ultrasound or other treatments.…”

Section: Resultssupporting

confidence: 68%

“…The results of this review show that the application of laser for the treatment of CTS can significantly improve the severity of symptoms of the condition. Some studies have suggested that HILT is more effective in reducing pain than LLLT [11] but other studies have reported a reduction in pain in LLLT as well [15,16,18] . This may be due to the different parameters of the laser application in the above studies, as different laser parameters can lead to different results [11,19] .…”

Section: Discussionmentioning

confidence: 99%

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The effect of laser therapy on the treatment of carpal tunnel syndrome symptoms

Papanikolaou¹,

Iakovidis²,

Lytras³

et al. 2021

Nat. J. Clin. Orthop.

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The carpal tunnel syndrome (CTS) is a common type of peripheral entrapment of the median nerve that occurs in the wrist and specifically in the carpal tunnel. Laser therapy is one of the most widely used therapies available to the physiotherapist for the treatment of symptoms in the management of patients with CTS. However, its exact effects as well as the appropriate treatment parameters have not been fully elucidated. The aim of this review is to describe recent research data on the efficacy of the application of laser in improving symptoms in patients with CTS as well as to provide data on device configurations and treatment time. The following databases were searched: PEDro, PubMed and Google Scholar, with the following keywords: carpal tunnel syndrome, physiotherapy, Low-Power Laser Therapy, High-Power Laser Therapy, rehabilitation. Both clinical studies and systematic reviews were included in the review and in total 10 articles were included. The results of this review show that laser treatment seems to have a positive effect on the treatment of symptoms in patients with CTS. However, the treatment parameters need to be further investigated, as different results can be obtained with different parameters.

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Section: Resultssupporting

confidence: 68%

Section: Discussionmentioning

confidence: 99%

The effect of laser therapy on the treatment of carpal tunnel syndrome symptoms

Papanikolaou¹,

Iakovidis²,

Lytras³

et al. 2021

Nat. J. Clin. Orthop.

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“…Current literature has focused on the efficacy of surgical and pharmacological treatments [8][9][10][11][12][13][14][15][16][17][18][19][20][21]. Regarding conservative treatments, most research evaluates the effects of electrophysical modalities (EM) in carpal tunnel syndrome (CTS) [22][23][24][25][26][27][28][29][30][31][32]. There is a gap in the study of entrapment injuries in other nerves and pathologies that represent a higher degree of disability, such as paralysis.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of electrophysical modalities in the sensorimotor rehabilitation of radial, ulnar, and median neuropathies: A meta-analysis

et al. 2021

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Introduction People with ulnar, radial or median nerve injuries can present significant impairment of their sensory and motor functions. The prescribed treatment for these conditions often includes electrophysical therapies, whose effectiveness in improving symptoms and function is a source of debate. Therefore, this systematic review aims to provide an integrative overview of the efficacy of these modalities in sensorimotor rehabilitation compared to placebo, manual therapy, or between them. Methods We conducted a systematic review according to PRISMA guidelines. We perform a literature review in the following databases: Biomed Central, Ebscohost, Lilacs, Ovid, PEDro, Sage, Scopus, Science Direct, Semantic Scholar, Taylor & Francis, and Web of Science, for the period 1980–2020. We include studies that discussed the sensorimotor rehabilitation of people with non-degenerative ulnar, radial, or median nerve injury. We assessed the quality of the included studies using the Risk of Bias Tool described in the Cochrane Handbook of Systematic Reviews of Interventions and the risk of bias across studies with the GRADE approach described in the GRADE Handbook. Results Thirty-eight studies were included in the systematic review and 34 in the meta-analysis. The overall quality of evidence was rated as low or very low according to GRADE criteria. Low-level laser therapy and ultrasound showed favourable results in improving symptom severity and functional status compared to manual therapy. In addition, the low level laser showed improvements in pinch strength compared to placebo and pain (VAS) compared to manual therapy. Splints showed superior results to electrophysical modalities. The clinical significance of the results was assessed by effect size estimation and comparison with the minimum clinically important difference (MCID). Conclusions We found favourable results in pain relief, improvement of symptoms, functional status, and neurophysiological parameters for some electrophysical modalities, mainly when applied with a splint. Our results coincide with those obtained in some meta-analyses. However, none of these can be considered clinically significant. Trial registration PROSPERO registration number CRD42020168792; https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=168792.

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“…A systematic review conducted in 2018 concluded that LLLT is more effective in treating CTS compared to placebo in the short term (16). One of the most recent meta-analysis studies conducted in 2020 has reported that adding low-level laser to splints exerts no significant impact on relieving hand pain and improving its functions compared to the use of splint alone; thus, low-level laser is not suggested to be used alongside splints for treating CTS patients (17).…”

Section: Introductionmentioning

confidence: 99%

Effect of Low-Level Laser Therapy Combined with Therapeutic Ultrasound on Hand Pain and Function Following Carpal Tunnel Syndrome: A Randomized Controlled Trial

Asadi

Saremi

Radinmehr

et al. 2021

Middle East J Rehabil Health Stud

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Background: Carpal tunnel syndrome (CTS) is the most prevalent compression neuropathy in the upper extremity. Objectives: The present study aimed to compare ultrasound and laser therapies separately and together in relieving hand pain and improving performance in mild and moderate CTS patients. Methods: In this single-blind trial, 45 patients (84 wrists) suffering from CTS were randomly divided into three treatment groups: the ultrasound and laser combination group (15 patients), the ultrasound therapy group (15 patients), and the laser therapy group (15 patients). Low-level laser therapy (total intensity of 9 J on 5 points) and ultrasound therapy (intensity of 1.25 W/cm and duty cycle of 20% for 5 minutes per session) were applied on the carpal tunnel for 10 sessions. For the ultrasound and laser combination group, the laser was first conducted in the same way for the laser therapy group, and ultrasound was performed immediately after, with the same parameters as those of the ultrasound therapy group. A visual analog scale (VAS), grip strength, pinch strength, and the Boston Questionnaire results were evaluated before and after the treatment. Results: All three treatment groups (the ultrasound and laser combination group, the ultrasound therapy group, and the laser therapy group) demonstrated significantly improved VAS (P=0.000, P = 0.000, and P = 0.000, respectively), grip strength (P = 0.003, P = 0.001, and P = 0.01, respectively), pinch strength (P = 0.000, P = 0.004, and P = 0.002, respectively), and Boston questionnaire results (P = 0.000, P = 0.000, and P = 0.000, respectively). However, a comparison of treatment groups' mean changes indicated no significant difference among them (P > 0.05). Conclusions: Both ultrasound and laser modalities effectively relieve pain and improve functional hand performance in patients with mild and moderate CTS in the short term. The compound use of these two modalities may have a greater impact in treating these patients.

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Low-level laser therapy for carpal tunnel syndrome: systematic review and network meta-analysis

Cited by 21 publications

References 35 publications

The effect of laser therapy on the treatment of carpal tunnel syndrome symptoms

The effect of laser therapy on the treatment of carpal tunnel syndrome symptoms

Effectiveness of electrophysical modalities in the sensorimotor rehabilitation of radial, ulnar, and median neuropathies: A meta-analysis

Effect of Low-Level Laser Therapy Combined with Therapeutic Ultrasound on Hand Pain and Function Following Carpal Tunnel Syndrome: A Randomized Controlled Trial

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