Low-level laser therapy versus local steroid injection in patients with idiopathic carpal tunnel syndrome: a single blind randomized comparative trial

Abstract

The objective of this study was to compare corticosteroid injection with low-level laser therapy for the short-term treatment of mild or moderate idiopathic carpal tunnel syndrome. Single blind randomized clinical trial was conducted from May 2010 to October 2010 in outpatient clinic and research center at a university hospital. Thirty-eight patients (female to male ratio was 5.3 to 1) with a new episode of carpal tunnel syndrome of mild or moderate severity participated in this study. Corticosteroid injection and low level laser therapy were used as the interventions. Primary outcome measure was the severity of the disease. Based on the electrophysiological findings, we proposed three grades: mild, moderate and severe. Visual analogue scores were used to measure subjective severity of pain. We measured median distal motor and sensory latencies. All participants were followed for two months. Analyses showed favorable outcomes in both groups in terms of visual analogue scores and median distal motor and sensory latencies (p<0.001 for all comparisons). Electrophysiologic studies did not imply any significant difference in the severity (Chi-squared test p = 0.28), and change in the grade of the disease between the two groups. Also there was no significant difference between the groups in mean visual analogue scores (Mann-Whitney test p = 0.45), median motor distal latency (Mann- Whitney test p = 0.08), and sensory distal latency (Mann-Whitney test p = 0.70), 8 weeks after the treatments. Both corticosteroid and laser are advantageous in the short-term treatment of carpal tunnel syndrome and provide satisfactory pain relief, electrophysiological improvement, and are well tolerated by patients.

Keywords: Carpal tunnel syndrome; Low level laser; Corticosteroid; Median nerve; Electrophysiologic studies; Peripheral compression neuropathy; Randomized clinical trial; Hydrocortisone