Skip to main content
Top
Published in: Clinical Rheumatology 9/2009

01-09-2009 | Original Article

Comparison of splinting and splinting plus low-level laser therapy in idiopathic carpal tunnel syndrome

Authors: Ilker Yagci, Ozlem Elmas, Eylem Akcan, Isil Ustun, Osman Hakan Gunduz, Zeynep Guven

Published in: Clinical Rheumatology | Issue 9/2009

Login to get access

Abstract

This study aimed to compare the short-term efficacy of splinting (S) and splinting plus low-level laser therapy (SLLLT) in mild or moderate idiopathic carpal tunnel syndrome (CTS) with a prospective, randomized controlled study. The patients with unilateral, mild, or moderate idiopathic CTS who experienced symptoms over 3 months were included in the study. The SLLLT group received ten sessions of laser therapy and splinting while S group was given only splints. The patients were evaluated at the baseline and after 3 months of the treatment. Follow-up parameters were nerve conduction study (NCS), Boston Questionnaire (BQ), grip strength, and clinical response criteria. Forty-five patients with CTS completed the study. Twenty-four patients were in S and 21 patients were in SLLLT group. In the third-month control, SLLLT group had significant improvements on both clinical and NCS parameters (median motor nerve distal latency, median sensory nerve conduction velocities, BQ symptom severity scale, and BQ functional capacity scale) while S group had only symptomatic healing (BQ symptom severity scale). The grip strength of splinting group was decreased significantly. According to clinical response criteria, in SLLLT group, five (23.8%) patients had full and 12 (57.1%) had partial recovery; four (19%) patients had no change or worsened. In S group, one patient (4.2%) had full and 17 (70.8%) partial recovery; six (25%) patients had no change or worsened. Additionally, applied laser therapy provided better outcomes on NCS but not in clinical parameters in patients with CTS.
Literature
1.
go back to reference Gerritsen AA, de Vet HC, Scholten RJ, Bertelsmann FW, de Krom MC, Bouter LM (2002) Splinting vs surgery in the treatment of carpal tunnel syndrome: a randomized controlled trial. JAMA 288(10):1245–1251PubMedCrossRef Gerritsen AA, de Vet HC, Scholten RJ, Bertelsmann FW, de Krom MC, Bouter LM (2002) Splinting vs surgery in the treatment of carpal tunnel syndrome: a randomized controlled trial. JAMA 288(10):1245–1251PubMedCrossRef
2.
go back to reference Demirci S, Kutluhan S, Koyuncuoglu HR, Kerman M, Heybeli N, Akkuş S, Akhan G (2002) Comparison of open carpal tunnel release and local steroid treatment outcomes in idiopathic carpal tunnel syndrome. Rheumatol Int 22(1):33–37PubMedCrossRef Demirci S, Kutluhan S, Koyuncuoglu HR, Kerman M, Heybeli N, Akkuş S, Akhan G (2002) Comparison of open carpal tunnel release and local steroid treatment outcomes in idiopathic carpal tunnel syndrome. Rheumatol Int 22(1):33–37PubMedCrossRef
3.
go back to reference Ucan H, Yagci I, Yilmaz L, Yagmurlu F, Keskin D, Bodur H (2006) Comparison of splinting, splinting plus local steroid injection and open carpal tunnel release outcomes in idiopathic carpal tunnel syndrome. Rheumatol Int 27(1):45–51PubMedCrossRef Ucan H, Yagci I, Yilmaz L, Yagmurlu F, Keskin D, Bodur H (2006) Comparison of splinting, splinting plus local steroid injection and open carpal tunnel release outcomes in idiopathic carpal tunnel syndrome. Rheumatol Int 27(1):45–51PubMedCrossRef
4.
go back to reference Botte MJ, von Schroeder HP, Abrams RA, Gellman H (1996) Recurrent carpal tunnel syndrome. Hand Clin 12(4):731–743PubMed Botte MJ, von Schroeder HP, Abrams RA, Gellman H (1996) Recurrent carpal tunnel syndrome. Hand Clin 12(4):731–743PubMed
5.
go back to reference Stolp-Smith KA, Pascoe MK, Ogburn PL Jr (1998) Carpal tunnel syndrome in pregnancy: frequency, severity, and prognosis. Arch Phys Med Rehabil 79(10):1285–1287PubMedCrossRef Stolp-Smith KA, Pascoe MK, Ogburn PL Jr (1998) Carpal tunnel syndrome in pregnancy: frequency, severity, and prognosis. Arch Phys Med Rehabil 79(10):1285–1287PubMedCrossRef
6.
go back to reference Manente G, Torrieri F, Di Balassio F, Staniscia T, Romano F, Uncini A (2001) An innovative hand brace for carpal tunnel syndrome: a randomized controlled trial. Muscle Nerve 24:1020–1025PubMedCrossRef Manente G, Torrieri F, Di Balassio F, Staniscia T, Romano F, Uncini A (2001) An innovative hand brace for carpal tunnel syndrome: a randomized controlled trial. Muscle Nerve 24:1020–1025PubMedCrossRef
7.
go back to reference Ayhan-Ardic FF, Erdem HR (2000) Long-term clinical and electrophysiological results of local steroid injection in patients with carpal tunnel syndrome. Funct Neurol 15(3):157–165PubMed Ayhan-Ardic FF, Erdem HR (2000) Long-term clinical and electrophysiological results of local steroid injection in patients with carpal tunnel syndrome. Funct Neurol 15(3):157–165PubMed
8.
go back to reference Giannini F, Passero S, Cioni R, Paradiso C, Battistini N, Giordano N, Vaccai D, Marcolongo R (1991) Electrophysiologic evaluation of local steroid injection in carpal tunnel syndrome. Arch Phys Med Rehabil 72(10):738–742PubMed Giannini F, Passero S, Cioni R, Paradiso C, Battistini N, Giordano N, Vaccai D, Marcolongo R (1991) Electrophysiologic evaluation of local steroid injection in carpal tunnel syndrome. Arch Phys Med Rehabil 72(10):738–742PubMed
9.
go back to reference Dammers JW, Veering MM, Vermeulen M (1999) Injection with methylprednisolone proximal to the carpal tunnel: randomised double blind trial. BMJ 319(7214):884–886PubMed Dammers JW, Veering MM, Vermeulen M (1999) Injection with methylprednisolone proximal to the carpal tunnel: randomised double blind trial. BMJ 319(7214):884–886PubMed
10.
go back to reference Ozdogan H, Yazici H (1984) The efficacy of local steroid injections in idiopathic carpal tunnel syndrome: a double-blind study. Br J Rheumatol 23(4):272–275PubMedCrossRef Ozdogan H, Yazici H (1984) The efficacy of local steroid injections in idiopathic carpal tunnel syndrome: a double-blind study. Br J Rheumatol 23(4):272–275PubMedCrossRef
11.
go back to reference O'Gradaigh D, Merry P (2000) Corticosteroid injection for the treatment of carpal tunnel syndrome. Ann Rheum Dis 59(11):918–919PubMedCrossRef O'Gradaigh D, Merry P (2000) Corticosteroid injection for the treatment of carpal tunnel syndrome. Ann Rheum Dis 59(11):918–919PubMedCrossRef
12.
go back to reference Ebenbichler GR, Resch KL, Nicolakis P, Wiesinger GF, Uhl F, Ghanem AH, Fialka V (1998) Ultrasound treatment for treating the carpal tunnel syndrome: randomised "sham" controlled trial. BMJ 316(7133):731–735PubMed Ebenbichler GR, Resch KL, Nicolakis P, Wiesinger GF, Uhl F, Ghanem AH, Fialka V (1998) Ultrasound treatment for treating the carpal tunnel syndrome: randomised "sham" controlled trial. BMJ 316(7133):731–735PubMed
13.
go back to reference Padua L, Padua R, Aprile I, Tonali P (1998) Noninvasive laser neurolysis in carpal tunnel syndrome. Muscle Nerve 21(9):1232–1233PubMedCrossRef Padua L, Padua R, Aprile I, Tonali P (1998) Noninvasive laser neurolysis in carpal tunnel syndrome. Muscle Nerve 21(9):1232–1233PubMedCrossRef
14.
go back to reference Weintraub MI (1997) Noninvasive laser neurolysis in carpal tunnel syndrome. Muscle Nerve 20(8):1029–1031PubMedCrossRef Weintraub MI (1997) Noninvasive laser neurolysis in carpal tunnel syndrome. Muscle Nerve 20(8):1029–1031PubMedCrossRef
15.
go back to reference Naeser MA, Hahn KA, Lieberman BE, Branco KF (2002) Carpal tunnel syndrome pain treated with low-level laser and microamperes transcutaneous electric nerve stimulation: a controlled study. Arch Phys Med Rehabil 83(7):978–988PubMedCrossRef Naeser MA, Hahn KA, Lieberman BE, Branco KF (2002) Carpal tunnel syndrome pain treated with low-level laser and microamperes transcutaneous electric nerve stimulation: a controlled study. Arch Phys Med Rehabil 83(7):978–988PubMedCrossRef
16.
go back to reference Bakhtiary AH, Rashidy-Pour A (2004) Ultrasound and laser therapy in the treatment of carpal tunnel syndrome. Aust J Physiother 50(3):147–151PubMed Bakhtiary AH, Rashidy-Pour A (2004) Ultrasound and laser therapy in the treatment of carpal tunnel syndrome. Aust J Physiother 50(3):147–151PubMed
17.
go back to reference Evcik D, Kavuncu V, Cakir T, Subasi V, Yaman M (2007) Laser therapy in the treatment of carpal tunnel syndrome: a randomized controlled trial. Photomed Laser Surg 25(1):34–39PubMedCrossRef Evcik D, Kavuncu V, Cakir T, Subasi V, Yaman M (2007) Laser therapy in the treatment of carpal tunnel syndrome: a randomized controlled trial. Photomed Laser Surg 25(1):34–39PubMedCrossRef
18.
go back to reference Shooshtari SM, Badiee V, Taghizadeh SH, Nematollahi AH, Amanollahi AH, Grami MT (2008) The effects of low level laser in clinical outcome and neurophysiological results of carpal tunnel syndrome. Electromyogr Clin Neurophysiol 48(5):229–231PubMed Shooshtari SM, Badiee V, Taghizadeh SH, Nematollahi AH, Amanollahi AH, Grami MT (2008) The effects of low level laser in clinical outcome and neurophysiological results of carpal tunnel syndrome. Electromyogr Clin Neurophysiol 48(5):229–231PubMed
19.
go back to reference Chang WD, Wu JH, Jiang JA, Yeh CY, Tsai CT (2008) Carpal tunnel syndrome treated with a diode laser: a controlled treatment of the transverse carpal ligament. Photomed Laser Surg 26:551–557PubMedCrossRef Chang WD, Wu JH, Jiang JA, Yeh CY, Tsai CT (2008) Carpal tunnel syndrome treated with a diode laser: a controlled treatment of the transverse carpal ligament. Photomed Laser Surg 26:551–557PubMedCrossRef
20.
go back to reference Dincer U, Cakar E, Kiralp MZ, Kilac H, Dursun H (2009) The effectiveness of conservative treatments of carpal tunnel syndrome: splinting, ultrasound, and low-level laser therapies. Photomed Laser Surg 27:119–125CrossRef Dincer U, Cakar E, Kiralp MZ, Kilac H, Dursun H (2009) The effectiveness of conservative treatments of carpal tunnel syndrome: splinting, ultrasound, and low-level laser therapies. Photomed Laser Surg 27:119–125CrossRef
21.
go back to reference Stevens JC (1997) AAEM mimimonograph # 26: the electrodiagnosis of carpal tunnel syndrome. Muscle Nerve 20(12):1477–1486PubMedCrossRef Stevens JC (1997) AAEM mimimonograph # 26: the electrodiagnosis of carpal tunnel syndrome. Muscle Nerve 20(12):1477–1486PubMedCrossRef
22.
go back to reference Levine DW, Simmons BP, Koris MJ, Daltroy LH, Hohl GG, Fossel AH, Katz JN (1993) A self-administered questionnaire for the assessment of severity of symptoms and functional status in carpal tunnel syndrome. J Bone and Joint Surg 75(11):1585–1592 Levine DW, Simmons BP, Koris MJ, Daltroy LH, Hohl GG, Fossel AH, Katz JN (1993) A self-administered questionnaire for the assessment of severity of symptoms and functional status in carpal tunnel syndrome. J Bone and Joint Surg 75(11):1585–1592
23.
go back to reference Heybeli N, Özerdemoğlu RA, Aksoy OG, Mumcu EF (2001) Karpal Tünel Sendromu: Cerrahi tedavi izleminde fonksiyonel ve semptomatik skorlama. Acta Orthop Traumatol Turc 35:147–151 Heybeli N, Özerdemoğlu RA, Aksoy OG, Mumcu EF (2001) Karpal Tünel Sendromu: Cerrahi tedavi izleminde fonksiyonel ve semptomatik skorlama. Acta Orthop Traumatol Turc 35:147–151
24.
go back to reference Heybeli N, Kutluhan S, Demirci S, Kerman M, Mumcu EF (2002) Assessment of outcome of carpal tunnel syndrome: a comparison of electrophysiological findings and a self-administered Boston questionnaire. J Hand Surg [Br] 27(3):259–264 Heybeli N, Kutluhan S, Demirci S, Kerman M, Mumcu EF (2002) Assessment of outcome of carpal tunnel syndrome: a comparison of electrophysiological findings and a self-administered Boston questionnaire. J Hand Surg [Br] 27(3):259–264
25.
go back to reference Mondelli M, Reale F, Sicurelli F, Padua L (2000) Relationship between the self-administered Boston questionnaire and electrophysiological findings in follow-up of surgically-treated carpal tunnel syndrome. J Hand Surg [Br] 25(2):128–134 Mondelli M, Reale F, Sicurelli F, Padua L (2000) Relationship between the self-administered Boston questionnaire and electrophysiological findings in follow-up of surgically-treated carpal tunnel syndrome. J Hand Surg [Br] 25(2):128–134
26.
go back to reference Schuind FA, Mouraux D, Robert C, Brassinne E, Rémy P, Salvia P, Meyer A, Moulart F, Burny F (2003) Functional and outcome evaluation of the hand and wrist. Hand Clin 19(3):361–369PubMedCrossRef Schuind FA, Mouraux D, Robert C, Brassinne E, Rémy P, Salvia P, Meyer A, Moulart F, Burny F (2003) Functional and outcome evaluation of the hand and wrist. Hand Clin 19(3):361–369PubMedCrossRef
27.
go back to reference Akkus S, Kutluhan S, Akhan G, Tunc E, Ozturk M, Koyuncuoglu HR (2002) Does fibromyalgia affect the outcomes of local steroid treatment in patients with carpal tunnel syndrome? Rheumatol Int 22(3):112–115PubMedCrossRef Akkus S, Kutluhan S, Akhan G, Tunc E, Ozturk M, Koyuncuoglu HR (2002) Does fibromyalgia affect the outcomes of local steroid treatment in patients with carpal tunnel syndrome? Rheumatol Int 22(3):112–115PubMedCrossRef
28.
go back to reference Irvine J, Chong SL, Amirjani N, Chan KM (2004) Double-blind randomized controlled trial of low-level laser therapy in carpal tunnel syndrome. Muscle Nerve 30(2):182–187PubMedCrossRef Irvine J, Chong SL, Amirjani N, Chan KM (2004) Double-blind randomized controlled trial of low-level laser therapy in carpal tunnel syndrome. Muscle Nerve 30(2):182–187PubMedCrossRef
Metadata
Title
Comparison of splinting and splinting plus low-level laser therapy in idiopathic carpal tunnel syndrome
Authors
Ilker Yagci
Ozlem Elmas
Eylem Akcan
Isil Ustun
Osman Hakan Gunduz
Zeynep Guven
Publication date
01-09-2009
Publisher
Springer-Verlag
Published in
Clinical Rheumatology / Issue 9/2009
Print ISSN: 0770-3198
Electronic ISSN: 1434-9949
DOI
https://doi.org/10.1007/s10067-009-1213-0

Other articles of this Issue 9/2009

Clinical Rheumatology 9/2009 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.