Treatment of mild to moderate carpal tunnel syndrome in patients with diabetic neuropathy using low level laser therapy versus ultrasound controlled comparative study

Abstract

AimThe aim of the present study was to investigate and compare between Low Level Laser Therapy (LLLT) and Ultrasound (US) in treatment of Carpal Tunnel Syndrome (CTS) using the advantage of application of treatment directly over the transverse carpal ligament, as well as over the course of the median nerve in the forearm simultaneously.DesignFifty patients (25–55 years) with diabetic neuropathy, diagnosed as unilateral carpal tunnel syndrome participated in the study. They were equally divided and randomly assigned into two groups; each group consisted of 25 patients.Materials and methodsPatients in group (A) received a program of IR Gallium Arsenide LLLT (wavelength 904 nm, average power 20 mW, laser probe 7 mm diameter), with a total application of 4.8 J, while patients in group (B) received a program of US (frequency 1 MHz, power 1.0 W/cm2, pulsed mode 1:5).Results & discussionThe results of our study showed that there were no statistical significance differences (P > 0.05) were observed between the two groups. It was concluded that both low level laser (20 mW power, 904 nm Wavelength) and ultrasound (1.0 w/cm2 power, 1 MHz frequency) are effective in the treatment of mild and moderate CTS patients.

Effectiveness of Low-Level Laser Therapy compared to Ultrasound in Patients With Carpal Tunnel Syndrome: A Systematic Review and Meta-analysis

“…For this reason, it was determined that these 2 studies should be analyzed along with other articles. Additionally, in another study, 32 the treated patients were different from the patients of other articles. In this study, the population consisted of peripheral neuropathy diabetic patients (T2DM) with mild to moderate CTS.…”

“…The wavelength of laser therapy in the studies by Dincer et al 29 28 The intensity and power used in all studies was 1.0 W/cm 2 . The total number of treatment sessions in the studies conducted by Dincer et al, 29 Bartkowiak et al, 33 Bakhtiary & Rashidy-Pour, 28 Ahmed et al, 32 Saeed et al, 30 and Tikiz et al 31 The analysis of the studied articles showed that there was no significant difference or significant clinical benefit in pain relief (SMD = 0.65; 95% CI: -0.1 to 1.41; P = 0.09), SSS (SMD = 0.24; 95% CI: -0.6 to 1.08; P = 0.57), FSS (SMD = 0.35; 95% CI: -0.45 to 1.15; P = 0.4), motor latency (SMD = 0.59; 95% CI: -0.39 to 1.58; P = 0.24), sensory latency (SMD = 0.47; 95% CI: -0.12 to 1.07; P = 0.12), hand grip strength (SMD = -0.17; 95% CI: -0.61 to 0.31; P = 0.27), and motor amplitude (SMD = -0.34; 95% CI: -0.8 to 0.11; P = 0.14) in treating CTS with ultrasound or LLLT. In all meta-analyses, the result of the heterogeneity test was significant and the I² statistic was calculated to be between 55% and 95%.…”

“…In general, 5 studies examined the sensory latency outcomes. The examination periods in Bakhtiary & Rashidy-Pour, 28 Dincer et al, 29 Saeed et al, 30 Ahmed et al, 32 and Tikiz et al 31 studies were 1 month, 1 & 3 months, 1 month, 6 weeks, and 3 & 6 and 12 months. Figure 6 shows the charts of this outcome at follow-up times of 1 month, 6 weeks, 3 months, 6 months, and 12 months.…”

Laser Acupuncture: A Concise Review

“…In a study of 50 patients with diabetes mellitus and mildto-moderate, unilateral, carpal tunnel syndrome, application of an infrared laser (20 mW; dose: 4.8 Joules) was compared with ultrasound applied to the symptomatic volar wrist. 15 One stimulation point was over the median nerve, 5 cm proximal to the volar wrist crease (approximate location of the PC 6 acupoint). The cohort receiving laser treatment had marked pain reduction (* 4.5 points on a 10-point visual analogue scale).…”

Effectiveness of combined ultrasound and exercise therapy in the treatment of carpal tunnel syndrome - randomized, placebo-controlled investigation

“…The US was applied in contact over the carpal tunnel area of the skin on the volar side of the wrist for 15 minutes. The 1 MHz frequency US mode was used in our study due to the fact that deeper penetration has the potential to reach the median nerve [18]. Before study inclusion of eligible participants, the US devise was calibrated.…”