Gabapentin as an adjuvant therapy to splinting in carpal tunnel syndrome (CTS): a systematic review and meta-analysis of randomized controlled trials

Abstract Background Carpal tunnel syndrome (CTS) is a common upper limb entrapment neuropathy; severe cases are treated surgically and mild to moderate can be managed conservatively. The purpose of this systematic review and meta-analysis was to define the efficacy of gabapentin as an adjuvant to splinting in the treatment of mild to moderate CTS. Methods A systematic search through 13 databases, randomized clinical trials (RCTs) reporting the use of gabapentin with splinting in CTS were included and analyzed. Results Three RCTs including 170 patients were eligible. There was no significant difference between gabapentin plus splinting and splinting alone in 5 measured parameters: (1) Symptom Severity Scale (SSS) [MD (95% CI) = − 0.76 (− 2.46–0.93), p = 0.378], (2) Functional Status Scale (FSS) [MD (95% CI) = − 0.23 (− 1.40–0.94), p = 0.701], (3) visual analogue scale (VAS) to assess pain [MD (95% CI) = − 0.6 (− 1.47–0.27), p = 0.174], (4) Grip strength [MD (95% CI) = − 0.11 (− 0.70–0.48), p = 0.718], and (5) pinch strength [MD (95% CI) = 0.72 (− 0.10–1.54), p = 0.083]. Conclusion This review provides low-quality evidence that gabapentin plus nocturnal splinting is not superior to splinting alone. More high-quality trials are needed to determine the role of this drug as an adjuvant in the management of CTS.

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Effectiveness of Low-Level Laser Therapy compared to Ultrasound in Patients With Carpal Tunnel Syndrome: A Systematic Review and Meta-analysis

Journal of lasers in medical sciences ◽

10.15171/jlms.2019.s15 ◽

2019 ◽

Vol 10 (5) ◽

pp. S82-S89 ◽

Cited By ~ 1

Author(s):

Seyed Mansoor Rayegani ◽

Mohammad Moradi-Joo ◽

Seyed Ahmad Raeissadat ◽

Mohammad Hasan Bahrami ◽

Maryam Seyed-Nezhad ◽

...

Keyword(s):

Systematic Review ◽

Carpal Tunnel Syndrome ◽

Laser Therapy ◽

Carpal Tunnel ◽

Meta Analysis ◽

Low Level Laser Therapy ◽

Level Laser ◽

Significant Difference ◽

Tunnel Syndrome ◽

Meta Analyses

Introduction: Carpal tunnel syndrome (CTS) is the most common type of peripheral entrapment neuropathy that occurs in the wrist area in a space called the carpal tunnel. Low-level laser therapy (LLLT) and ultrasound are among the most common methods of physical modalities for treating CTS; the effectiveness of these 2 methods and the superiority of one over the other are not agreed among experts. Methods: In the present systematic review and meta-analysis study, the most important databases including PubMed, Cochrane Library, Scopus, Centre for Reviews and Dissemination, Science Direct, Trip medical database and Google Scholar were searched using appropriate keywords and specific strategies without time limitation to collect data. The collected data was analyzed using the meta-analytic method and the random-effects model. The heterogeneity among studies was examined using I2 . The data were analyzed using Review Manager Software. Results: From among 108 related studies, 49 cases were entered for the first stage. After the final examination, 6 studies were selected for meta-analysis. The total number of patients in these 6 studies was 403; 204 subjects were in the LLLT group and 199 subjects were in the ultrasound group. The results of the meta-analyses showed that there was no significant difference between these 2 therapeutic methods in terms of pain relief, symptom severity scale (SSS), functional status scale (FSS), motor latency, sensory latency, hand grip strength, and motor amplitude. Conclusion: Based on the meta-analyses, there was no significant difference between the 2 LLLT and ultrasound methods; in other words, they had similar effectiveness in improving the condition of patients with CTS. However, the authors believe that arriving at conclusions in this area requires high-quality and large size studies.

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Platelet-rich plasma in non-operative management of mild to moderate carpal tunnel syndrome – A systematic review & meta-analysis of short-term outcomes

Journal of Orthopaedics ◽

10.1016/j.jor.2021.05.004 ◽

2021 ◽

Author(s):

Martin S. Davey ◽

Matthew G. Davey ◽

Eoghan T. Hurley ◽

J. Tristan Cassidy ◽

Hannan Mullett ◽

...

Keyword(s):

Systematic Review ◽

Carpal Tunnel Syndrome ◽

Carpal Tunnel ◽

Platelet Rich Plasma ◽

Meta Analysis ◽

Operative Management ◽

Short Term ◽

Tunnel Syndrome ◽

Non Operative Management

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Systematic review and meta-analysis of surgical options for recurrent or persistent carpal tunnel syndrome: simple decompression versus coverage of the median nerve

Journal of Hand Surgery (European Volume) ◽

10.1177/17531934211001715 ◽

2021 ◽

pp. 175319342110017

Author(s):

Saskia F. de Roo ◽

Philippe N. Sprangers ◽

Erik T. Walbeehm ◽

Brigitte van der Heijden

Keyword(s):

Systematic Review ◽

Carpal Tunnel Syndrome ◽

Median Nerve ◽

Carpal Tunnel ◽

Carpal Tunnel Release ◽

Meta Analysis ◽

Surgical Techniques ◽

Open Release ◽

Flap Coverage ◽

Tunnel Syndrome

We performed a systematic review on the success of different surgical techniques for the management of recurrent and persistent carpal tunnel syndrome. Twenty studies met the inclusion criteria and were grouped by the type of revision carpal tunnel release, which were simple open release, open release with flap coverage or open release with implant coverage. Meta-analysis showed no difference, and pooled success proportions were 0.89, 0.89 and 0.85 for simple open carpal tunnel release, additional flap coverage and implant groups, respectively. No added value for coverage of the nerve was seen. Our review indicates that simple carpal tunnel release without additional coverage of the median nerve seems preferable as it is less invasive and without additional donor site morbidity. We found that the included studies were of low quality with moderate risk of bias and did not differentiate between persistent and recurrent carpal tunnel syndrome.

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Utility of Ultrasound Elastography in Evaluation of Carpal Tunnel Syndrome: A Systematic Review and Meta-analysis

Ultrasound in Medicine & Biology ◽

10.1016/j.ultrasmedbio.2019.07.409 ◽

2019 ◽

Vol 45 (11) ◽

pp. 2855-2865 ◽

Cited By ~ 14

Author(s):

Chih-Peng Lin ◽

Ing-Jeng Chen ◽

Ke-Vin Chang ◽

Wei-Ting Wu ◽

Levent Özçakar

Keyword(s):

Systematic Review ◽

Carpal Tunnel Syndrome ◽

Carpal Tunnel ◽

Meta Analysis ◽

Ultrasound Elastography ◽

Tunnel Syndrome

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Ultrasound-guided corticosteroid injection for patients with carpal tunnel syndrome: a systematic review and meta-analysis of randomized controlled trials

10.21203/rs.3.rs-125732/v1 ◽

2020 ◽

Author(s):

Fu-An Yang ◽

Ya-Chu Shih ◽

Jia-Pei Hong ◽

Chin-Wen Wu ◽

Chun-De Liao ◽

...

Keyword(s):

Systematic Review ◽

Carpal Tunnel Syndrome ◽

Randomized Controlled Trials ◽

Carpal Tunnel ◽

Corticosteroid Injection ◽

Meta Analysis ◽

Controlled Trials ◽

Ultrasound Guided ◽

Randomized Controlled ◽

Tunnel Syndrome

Abstract Carpal tunnel syndrome (CTS) refers to the symptoms and signs caused by the compression of the median nerve in the carpal tunnel. It can be treated by corticosteroid injection into the carpal tunnel. Two methods for injection have been employed, namely ultrasound-guided and landmark-guided injection. This systematic review and meta-analysis was conducted to compare these methods in terms of several outcomes. Randomized controlled trials (RCTs) were identified, and data collection was completed on 7 October 7, 2020. Results for continuous variables are expressed as standardized mean differences (SMDs) with 95% confidence intervals (CIs). Analyses were performed using RevMan 5.3 software. The analysis included eight RCTs published between 2013 and 2019 with a total of 448 patients. Ultrasound-guided injection yielded more favorable results for the Boston Carpal Tunnel Syndrome Questionnaire, Symptom Severity Scale [SMD = −0.49, 95% CI (−0.74, −0.25), P < 0.0001], Boston Carpal Tunnel Syndrome Questionnaire, Functional Status Scale [SMD = −0.24, 95% CI (−0.42, −0.06), P = 0.01], distal motor latency [SMD = −0.36, 95% CI (−0.70, −0.02), P = 0.04], and compound muscle action potential [SMD = 0.38, 95% CI (0.16, 0.61), P = 0.0008] . Ultrasound-guided corticosteroid injection is recommended for patients with CTS.

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