Use of Sonophoresis with Corticosteroids in Carpal Tunnel Syndrome: Systematic Review and Meta-Analysis

Abstract

Carpal tunnel syndrome is a neuropathic disease. It is one of the most frequent musculoskeletal pathologies affecting the upper limbs. One of most frequently used non-surgical treatments is corticosteorids. There are several alternatives for corticosteroids administration. One of them is phonophoresis, this being an effective and painless method of treatment. A systematic review and meta-analysis have been conducted over the use of phonophoresis with corticosteroids for the treatment of carpal tunnel syndrome compared to other non-surgical treatment methods. Keywords from Medical Subjects Headings (MeSH) were used in the following databases: Wos, Scopus, CINHAL, SciELO and PeDro. A total of 222 potentially relevant articles were retrieved. Eleven articles analysing the efficacy of phonophoresis with corticosteroids in reducing pain symptoms in individuals with carpal tunnel syndrome were included, 10 of which were used to conduct the meta-analysis. A conclusion could not be reached as to the application of phonophoresis with corticosteroids being better than other treatment methods, except for the perception of pain and an improved motor and sensory nerve conduction in cases of mild to moderate carpal tunnel syndrome.

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

“…When iontophoresis was compared to local injection of corticosteroids in the study by Aygül et al [27], the control intervention showed better results for median sensory nerve conduction velocity. Dexamethasone and betamethasone were the main drugs used in our included trials, which agrees with the previous review of Martín-Vega et al [11] that examined the effects of phonophoresis in the same target population. The use of these drugs has been reported to be effective for pain and inflammatory processes [34,35].…”

“…However, no therapeutic supremacy was recorded in the meta-analysis against comparator interventions [21][22][23][24][25]27]. This is in line with the results reported by Martín-Vega et al [11], in which the…”

“…However, no therapeutic supremacy was recorded in the meta-analysis against comparator interventions [21][22][23][24][25]27]. This is in line with the results reported by Martín-Vega et al [11], in which the effects of iontophoresis plus corticosteroids showed similar results to phonophoresis with corticosteroids [22,24,25,27].…”

“…Regarding the severity of CTS, most of our analyzed studies focused on mild to moderate cases, as in the review of Martín-Vega FJ et al [11], for phonophoresis. This fact could be related to the fact that most severe cases used to be treated with invasive approaches or surgery [33].…”

“…Rehabilitation and surgery are the principal therapeutic approaches in people diagnosed with CTS. Within the scientific literature, the other therapeutic options that have been systematically reviewed in CTS include: shock waves (based on high energy waves) [10], phonophoresis (based on ultrasounds) [11], or injections (use of steroids, cortisone) [12]. One of the therapeutic options for this condition that needs further study is iontophoresis.…”