Skip to main content

Advertisement

Log in

Low-level laser in the treatment of carpal tunnel syndrome: clinical, electrophysiological, and ultrasonographical evaluation

  • Original Article
  • Published:
Rheumatology International Aims and scope Submit manuscript

Abstract

The objective of this study is to investigate the efficacy of low-level laser therapy (LLLT) in patients with carpal tunnel syndrome (CTS). Sixty patients with CTS were included in this placebo-controlled and double-blind study and randomly assigned to three treatment groups: active laser with a dosage of 1.2 J/per painful point, active laser with a dosage of 0.6 J/per painful point, and placebo groups. A total of 5 points across the median nerve trace were irradiated with Gal-Al-As diode laser. All groups were treated 5 times per week for 3 weeks. Clinical assessments included pain intensity, grip strength, symptom severity score (SSS), functional status score (FSS), nerve conduction studies, and cross-sectional area (CSA) of the median nerve as measured by ultrasonography. Compared to baseline, post-treatment VAS scores (group 1, P < 0.001; group 2, P < 0.001; group 3, P < 0.01), grip strength (P < 0.05), SSS scores (group 1, P < 0.001; group 2, P < 0.001; group 3, P < 0.01), and FSS scores (P < 0.05) improved significantly in all groups. Only sensorial nerve velocity measurements on the palmar region showed a significant improvement in both active laser groups (P < 0.01). There was no significant difference in any of the outcome measures among the groups. With the chosen laser type and dose regimen, the results suggested that LLLT was no more effective than placebo in CTS.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Aroori S, Spence RAJ (2008) Carpal tunnel syndrome. Ulster Med J 77:6–17

    PubMed  Google Scholar 

  2. Atroshi I, Gummesson C, Johnsson R, Ornstein E, Ranstam J, Rosén I (1999) Prevalence of carpal tunnel syndrome in a general population. JAMA 282:153–158

    Article  PubMed  CAS  Google Scholar 

  3. Kao SY (2003) Carpal tunnel syndrome as an occupational disease. J Am Board Fam Pract 16:533–542

    Article  PubMed  Google Scholar 

  4. Werner RA, Andary M (2002) Carpal tunnel syndrome: pathophysiology and clinical neurophysiology. Clin Neurophysiol 113:1373–1381

    Article  PubMed  Google Scholar 

  5. Rempel DM, Diao E (2004) Entrapment neuropathies: pathophysiology and pathogenesis. J Electromyogr Kinesiol 14:71–75

    Article  PubMed  Google Scholar 

  6. Hirata H, Nagakura T, Tsujii M, Morita A, Fujisawa K, Uchida A (2004) The relationship of VEGF and PGE2 expression to extracellular matrix remodelling of the tenosynovium in the carpal tunnel syndrome. J Pathol 204:605–612

    Article  PubMed  CAS  Google Scholar 

  7. Tucci MA, Barbieri RA, Freeland AE (1997) Biochemical and histological analysis of the flexor tenosynovium in patients with carpal tunnel syndrome. Biomed Sci Instrum 33:246–251

    PubMed  CAS  Google Scholar 

  8. Koenig RW, Pedro MT, Heinen CPG, Schmidt T, Richter HP, Antoniadis G et al (2009) High-resolution ultrasonography in evaluating peripheral nerve entrapment and trauma. Neurosurg Focus 26:1–6

    Article  Google Scholar 

  9. Moran L, Perez M, Esteban A, Bellon J, Arranz B, del Cerro M (2009) Sonographic measurement of cross-sectional area of the median nerve in the diagnosis of carpal tunnel syndrome: correlation with nerve conduction studies. J Clin Ultrasound 37:125–131

    Article  PubMed  Google Scholar 

  10. Bland JDP (2007) Carpal tunnel syndrome. BMJ 335:343–346

    Article  PubMed  Google Scholar 

  11. Yagci I, Elmas O, Akcan E, Ustun I, Gunduz OH, Guven Z (2009) Comparison of splinting and splinting plus low-level laser therapy in idiopathic carpal tunnel syndrome. Clin Rheumatol 28:1059–1065

    Article  PubMed  Google Scholar 

  12. Evcik D, Kavuncu V, Cakir T, Subası V, Yaman M (2007) Laser therapy in the treatment of carpal tunnel syndrome: a randomized controlled trial. Photomed Laser Surg 25:34–39

    Article  PubMed  Google Scholar 

  13. Elwakil TF, Elazzazi A, Shokeir H (2007) Treatment of carpal tunnel syndrome by low-level laser versus open carpal tunnel release. Lasers Med Sci 22:265–270

    Article  PubMed  Google Scholar 

  14. Bakhtiary AH, Rashidy-Pour A (2004) Ultrasound and laser therapy in the treatment of carpal tunnel syndrome. Aust J Physiother 50:147–151

    PubMed  Google Scholar 

  15. Bae CS, Lim SC, Kim KY, Song CH, Pak S, Kim SG, Jang CH (2004) Effect of Ga-as laser on the regeneration of injured sciatic nerves in the rat. In Vivo 18:489–495

    PubMed  Google Scholar 

  16. Vinck E, Coorevits P, Cagnie B, De Muynck M, Vanderstraeten G, Cambier D (2005) Evidence of changes in sural nerve conduction mediated by light emitting diode irradiation. Lasers Med Sci 20:35–40

    Article  PubMed  Google Scholar 

  17. Medrado AR, Pugliese LS, Reis SR, Andrade ZA (2003) Influence of low level laser therapy on wound healing and its biological action upon myofibroblasts. Lasers Surg Med 32:239–244

    Article  PubMed  Google Scholar 

  18. Boschi ES, Leite CE, Saciura VC, Caberlon E, Lunardelli A, Bitencourt S, Melo DA, Oliveira JR (2008) Anti-Inflammatory effects of low-level laser therapy (660 nm) in the early phase in carrageenan-induced pleurisy in rat. Lasers Surg Med 40:500–508

    Article  PubMed  Google Scholar 

  19. Ferreira DM, Zângaro RA, Villaverde AB, Cury Y, Frigo L, Picolo G, Longo I, Barbosa DG (2005) Analgesic effect of He-Ne (632.8 nm) low-level laser therapy on acute inflammatory pain. Photomed Laser Surg 23:177–181

    Article  PubMed  CAS  Google Scholar 

  20. Irvine J, Chong SL, Amirjani N, Chan KM (2004) Double-blind randomized controlled trial of low-level laser therapy in carpal tunnel syndrome. Muscle Nerve 30:182–187

    Article  PubMed  Google Scholar 

  21. Levine D, Simmons BP, Koris MJ, Daltory LH, Hohl GG, Fossel AH, Katz JN (1993) A self-administered questionnaire for the assessment of severity of symptoms and functional status in carpal tunnel syndrome. J Bone Joint Surg (Am) 75:1585–1592

    CAS  Google Scholar 

  22. Sezgin M, Incel NA, Serhan S, Camdeviren H, As I, Erdogan C (2006) Assessment of symptom severity and functional status in patients with carpal tunnel syndrome: reliability and functionality of the Turkish version of the Boston Questionnaire. Disabil Rehabil 28:1281–1285

    Article  PubMed  Google Scholar 

  23. Shooshtari SM, Badiee V, Taghizadeh SH, Nematollahi AH, Amanollahi AH, Grami MT (2008) The effects of low level laser in clinical outcome and neurophysiological results of carpal tunnel syndrome. Electromyogr Clin Neurophysiol 48:229–231

    PubMed  CAS  Google Scholar 

  24. Walker J (1083) Relief from chronic pain by low power laser irradiation. Neurosci Lett 43:339–344

    Article  Google Scholar 

  25. Bjordal JM, Lopes-Martins RA, Iversen VV (2006) A randomized, placebo controlled trial of low level laser therapy for activated Achilles tendinitis with microdialysismeasurement of peritendinous prostaglandin E2 concentrations. Br J Sports Med 40:76–80

    Article  PubMed  CAS  Google Scholar 

  26. Jarvis D, MacIver B, Tanelian DL (1990) Electrophysiologic recording and thermodynamic modeling demonstrate that helium-neon laser irradiation does not affect peripheral Aδ- or C-fiber nociceptors. Pain 43:235–242

    Article  PubMed  CAS  Google Scholar 

  27. Rochkind S, Drory V, Alon M, Nissan M, Ouaknine GE (2007) Laser phototherapy (780 nm), a new modality in treatment of long-term incomplete peripheral nerve injury: a randomized double-blind placebo-controlled study. Photomed Laser Surg 25:436–442

    Article  PubMed  Google Scholar 

  28. Bagis S, Comelekoglu U, Sahin G, Buyukakilli B, Erdogan C, Kanik A (2002) Acute electrophysiologic effect of pulsed gallium-arsenide low energy laser irradiation on configuration of compound nerve action potential and nerve excitability. Lasers Surg Med 30:376–380

    Article  PubMed  Google Scholar 

  29. Bagis S, Comelekoglu U, Coskun B, Milcan A, Buyukakilli B, Sahin G, Ozisik S, Erdogan C (2003) No effect of GA-AS (904 nm) laser irradiation on the intact skin of the injured rat sciatic nerve. Lasers Med Sci 18:83–88

    Article  PubMed  CAS  Google Scholar 

  30. Beckerman H, de Bie RA, De Cuyper HJ, Oostendorp RAB (1992) The efficacy of laser therapy for musculoskeletal and skin disorders: a criteria-based meta-analysis of randomized clinical trials. Phys Ther 7:483–491

    Google Scholar 

  31. Turner JA, Deyo RA, Loeser JD, Von Korff M, Fordyce WE (1994) The importance of placebo effects in pain treatment and research. JAMA 271:1609–1614

    Article  PubMed  CAS  Google Scholar 

  32. Zubieta JK, Stohler CS (2009) Neurobiological mechanisms of placebo responses. Ann N Y Acad Sci 1156:198–210

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Funda Tascioglu.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Tascioglu, F., Degirmenci, N.A., Ozkan, S. et al. Low-level laser in the treatment of carpal tunnel syndrome: clinical, electrophysiological, and ultrasonographical evaluation. Rheumatol Int 32, 409–415 (2012). https://doi.org/10.1007/s00296-010-1652-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00296-010-1652-6

Keywords

Navigation