The effects of high intensity laser therapy on pain, functional status, hand grip strength and median nerve cross section in ultrasonography in patients with carpal tunnel syndrome

Objective: In this study, it was aimed to evaluate the effects of HILT treatment on pain, functional status and hand grip strength in patients with carpal tunnel syndrome (CTS) and on the median nerve area in USG. Material and methods: This study was planned as a prospective, randomized, controlled study. It was planned to include 60 CTS patients with CTS symptoms and signs who applied to Necmettin Erbakan University Meram Medical Faculty Physical Medicine and Rehabilitation, Neurology outpatient clinics. Sixty patients diagnosed with mild and moderate CTS by physical examination and electrophysiological findings were included in the study. Visual analog scale (VAS), Boston CTS Questionnaire (BCTQ), hydraulic hand dynamometer (Jamar) and USG were used for evaluation. The patients were randomly divided into two groups as real LASER+ TENS+ exercises+ splint and sham LASER+ TENS+ exercises+ splint treatment groups. All patients were evaluated before treatment, after treatment and at 3 months. Results: While there was a statistically significant increase in hand grip strength at the end of the 3rd month in both groups (p<0.001), a statistically significant increase was found only in the HİLT group after treatment (p<0.001). There was no superiority between the groups on the change in hand grip strength (p=0.449). There was a significant difference between median nerve cross-sectional area values before treatment, but this difference was in favor of disease severity in the HİLT group (p=0.013). While significant improvement was observed in vii the HİLT group after treatment (p<0.001), no significant improvement was observed in the sham group (p=0.931). In the 3rd month controls, a statistically significant improvement was observed in the cross-sectional area measurements of the median nerve in both groups (p values p<0.001 for HİLT, p=0.007 for the sham group). While a significant improvement was observed in the BCTQ SSS-FSS scores and VAS values for pain in the pre-treatment-post-treatment and pre-treatment-3nd month controls for all 3 evaluation parameters (p<0.001), no statistically significant superiority was found between the groups (p values were p=0.973, p=0.226, p=0.454, respectively). Conclusion: For patients with mild and moderate CTS, high-intensity laser therapy combined with a standard physical therapy program was found to be more effective than physical therapy alone in the early period in improving hand grip strength and median nerve cross-sectional area parameters measured on USG. Although there is no definite consensus on the standard treatment protocol in CTS patients, it seems safe to add YYLT to the conventional treatment program.