Effectiveness of LOW level lase therapy in carpal tunnel syndrome: Ultrasonographic and electrophysiological evaulation

Carpal Tunnel Syndrome (CTS) is the most common type of entrapment neuropathy. CTS is defined as the sign and symptoms due to compression of the median nerve in the carpal tunnel. Conservative therapy is usually considered as the first step in the management of CTS. Low level laser therapy (LLLT) is among the new physical modalities, which have shown therapeutic effects in CTS. The aim of the present study was to evaluate electrophysiological and ultrasonographical effectiveness of LLLT. Fourty two patients with mild and moderate CTS who met inclusion criteria were included this study. The patients were randomly assigned into two groups. First group received 15 sessions of LLLT (4 joule/ per session) over the carpal tunnel area and three weeks wrist splinting. Second group received 15 session of sham LLLT and wrist splinting. Electroneurophysiological parameters (motor and sensory nerve conduction studies of median nerve), ultrasonographical parameters (cross sectional area, palmar bowing, flattening ratio nd power doppler), Boston Scale (symptom severity and functional capacity) and clinical parameters were evaluated at baseline and three weeks after treatment. Night paresthesia improved in both groups, however there were no statistically significant difference between the groups. FSS and SSS scores improved only in the LLLT group. Additionally median sensory nerve conduction velocities and amplitudes showed significant improvement only in the LLLT group. Also cross sectional area and vascularisation of the median nerve showed significant improvement only in the LLLT group. İn conclusion; these results suggest that LLLT may be good conservative treatment method for CTS due to improvement in clinical, electrophysiological and ultrasonographical parameters. LLLT is an easily applied, non-invasive treatment option for CTS however the therapeutic mechanism is not completely understood. Therapeutic effect of LLLT is thought to be dose dependent, but minimal effective dose and wave lenght stil remains controversial. Further studies with long-term follow-up should be well considered.