The effects of steroid phonophoresis on clinical parameters and nerve conduction velocities in carpal tunnel syndrome

The effects of steroid phonophoresis on clinical parameters and nerve conduction velocities in carpal tunnel syndromeThis study was aimed to investigate the effects of steroid phonophoresis on electroneurophysiological and clinical parameters and compare these effects with ultrasound (US) and sham US in carpal tunnel syndrome.44 patients (all female, 81 hands) with the diagnosis of carpal tunnel syndrome were included in the study. Patients were randomised to phonophoresis (n=27 hands), US (n=28 hands) and sham US (n=26 hands) groups. Steroid phonophoresis, using dexamethasone as a conductive agent, at 1.0 W/cm2 was applied to the phonophoresis group. Ultrasound at 1.0 W/cm2 was applied to the US group. Sham ultrasound at 0.0 W/cm2 was applied to the sham US group. All of the groups received tendon and nerve gliding exercises. Electroneurophysiological parameters (distal motor latency and sensory nerve conduction velocities of median nerve), visual analogue scale (VAS) and Boston Scale (symptom severity and functional capacity) were assessed at the beginning of the treatment, after the treatment and on the third month.All of the variables were significantly improved at the end of the treatment and at control evaluation in steroid phonophoresis group. VAS, symptom severity and functional capacity of Boston scale were improved in US and sham US groups. Additionally, sensory nerve conduction velocities were also improved in sham US group.Steroid phonophoresis has favorable effects on nerve conduction studies, clinical findings and patient based assessments and these effects last longer when compared with ultrasound. Favorable effects on clinical findings and patient based assessments of US and sham US groups suggests the effectiveness of tendon and nerve gliding exercises in the treatment of carpal tunnel syndrome.Keywords: Boston Scale, carpal tunnel syndrome, EMG, steroid phonophoresis, ultrasound