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

Introduction/Objective. The aim of the paper was to evaluate the short-term effectiveness of ultrasound treatment procedure on defined clinical parameters and changes of electrodiagnostic parameters at the median nerve in carpal tunnel syndrome patients. Methods. Thirty-five patients (50 hands) were randomly divided into two groups: the experimental group (EG) (20 patients (29 hands)) and the control group (CG) (15 patients (21 hands)). Twenty sessions of ultrasound treatment were performed over a period of seven weeks and control examination was performed during the eighth week from the initial session. Clinical assessment parameters (pain intensity, superficial sensibility, and Tinel sign), and electrodiagnostic parameters (motor distal latency – mDL), median sensory nerve conduction velocity (SNCV), and median sensory nerve action potential (SNAP) were assessed both at baseline (T1) and at control (T2). Results. There is significant improvement of pain intensity (T1 – 10.4/58.6/31; T2 – 65.5/27.6/6.9; p < 0.001) and superficial sensibility (T1 – 3.4/69/27.6; T2 – 44.8/34.5/20.7; p < 0.001) in the EG after the treatment. In the EG, there is significant reduction in frequency of positive Tinel’s sign (T1 – 100/0; T2 – 62.1/37.9; p < 0.001), and mDL significantly decreased after the treatment (T1 – 4.7 ± 1.3; T2 – 4.5 ± 1.2; p = 0.007), while SNAP (T1 – 20.2 ± 15.4; T2 – 24.4 ± 16.5; p < 0.001) and SNCV (T1 – 36.5 ± 9.8; T2 – 42.6 ± 9.7; p < 0.001) significantly increased. Conclusion. Ultrasound treatment along with exercises have positive short-term effects and benefits on improvement of clinical and electrodiagnostic findings in individuals with carpal tunnel syndrome.