Ultrasonographic imaging of the effects of continuous, pulsed or sham ultrasound treatments on carpal tunnel syndrome: A randomized controlled study.

Background: Clinical and electrophysiological effects of therapeutic ultrasound (US) were researched in many studies on patients with CTS with conflicting results.

Objective: To assess the effects of continuous and pulsed US treatments by ultrasonographic imaging in addition to clinical and electrophysilogical parameters in patients with carpal tunnel syndrome (CTS).

Method: Fifty-four patients with idiopathic CTS were randomly divided into three groups. All patients used night splints for two weeks. In addition to splint therapy, continuous, pulsed or sham US treatments were applied to patients 10 min/session, 5 sessions/week for two weeks. Clinical situation (pain, hand function, strength), electrophysiological studies (motor distal latency, MDL, sensorial distal latency, SDL), and ultrasonographic area measurements of median nerve were evaluated. All evaluations were applied at pretreatment (baseline), posttreatment (2nd week) and in the 6th week.

Results: Whereas significant differences were detected for clinical, functional and ultrasonographic imaging findings in each group in the 2nd week and 6th week compared to baseline (p< 0.0167 for both), no electrophysiological improvements were detected in pulsed-US (p> 0.0167) and only improvement for SDL in sham US group in the 2nd week evaluation (p< 0.0167).

Conclusion: According to the results of this study, continuous, pulsed or sham US treatments combined with splinting had similar effects on clinical, electrophysiological and ultrasonographic imaging improvements. Additionally, ultrasonographic imaging may be a preferable objective evaluation tool to prove the early posttreatment clinical improvements when electrophysiological changes could not be detected.