Comparative therapeutic efficiency of ultrasound, laser, and interferential current modalities in the management of carpal tunnel syndrome

Abstract

Objectives: To investigate and compare the immediate electrophysiological, clinical, and short term follow up clinical efficacies of ultrasound, laser and interferential current in the management of primary carpal tunnel syndrome. Methods: Eighty-four Patients (66 females and 18 males) with clinical and electrophysiological diagnosis of carpal tunnel syndrome were divided randomly into three treatment groups at King Faisal University. First group: received ultrasound therapy (3 MHz, 1 watt/cm2, 5 min/session), the second group: received laser therapy(100% intensity; 9 joules applied for 15 minutes per session), and the third group: received interferential current therapy (70 Hz for 20 minutes). Therapy was applied for a total of 11 sessions over a period of three weeks. Electrophysiological measurements established before and immediate after treatment. Clinical evaluation was performed before, immediate, 2 and 6 months after treatment. Clinical evaluation parameters included pain assessment by visual analogue scale and frequency of awaking from sleep. Results: There was statistically significant improvement in both immediate electrophysiological and clinical parameters after treatment by three modalities used in this study with different level of improvement. Improvement was significantly more pronounced in the interferential current group (85.7%), followed by ultrasound group (75%), laser (57.1%). After 2 months follow up, there was deterioration in all three groups in the clinical symptoms, which was further declined in 6 months period. Conclusions: The results of this study suggest a beneficially immediate effect of local treatment of median nerve in patients with idiopathic carpal tunnel syndrome with ultrasound, laser and interferential current therapies. The group of patients with mild grade of showed the best response among the others. Short-term (2 and 6 months) follow up did not support initial results and the short-term clinical benefits of this treatment were not found in our study.