scholarly journals Effectiveness of neural mobilization and ultrasound therapy on pain severity in carpal tunnel syndrome

2018 ◽  
Vol 5 (4) ◽  
pp. 2187-2193
Author(s):  
Mehboob Alam ◽  
Muhammad Khan ◽  
Syed Imran Ahmed ◽  
Syed Shahzad Ali
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Successful Treatment ◽  
Carpal Tunnel ◽  
Severe Pain ◽  
Pain Severity ◽  
Ultrasound Therapy ◽  
Mild Pain ◽  
Tunnel Syndrome ◽  
Group 2 ◽  
Group 1

Objective: To compare the effectiveness of neural mobilization and ultrasound therapy on pain severity in carpal tunnel syndrome (CTS). Methods: This randomized controlled trial was conducted on 48 CTS patients at the Physiotherapy Department IPM&R, DUHS between 23rd January 2017 and 22nd July 2017. The CTS patients were randomly allocated into 2 equal groups by simple randomization method. Group 1 received neural mobilisation; Group 2 received ultrasound therapy with a predetermined intensity. A total of 12 sessions were given over a period of 4 weeks. Pre and post intervention data were collected from both groups on Visual Analogue Scale (VAS) to measure pain. SPSS version 20 was used for data analysis. Comparisons between post test results of both groups were done by using paired sample t-test with a p-value < 0.05 considered as significant. Results: It was found that the 79% (19 cases) and 21% (5 cases) in Group 1 (Neural Mobilization), who prior to the treatment had faced moderate and severe pain, respectively, all experienced successful treatment. Indeed, after treatment 100% (24) of the cases only experienced mild pain, indicating successful treatment. For Group 2 (Ultrasound Therapy), 54% (13) and 46% (11) of cases were with moderate and severe pain before treatment; after administering the treatment 20% (5 cases) had mild pain and 80% (19 cases) had moderate pain. Conclusion: Neural mobilization for median nerve is more beneficial than ultrasound therapy in reducing pain intensity and functional limitations due to CTS.

scholarly journals Efficacy of Hyalase Hydrodissection in the Treatment of Carpal Tunnel Syndrome: A Randomized, Double-Blind, Controlled, Clinical Trial

2020 ◽  
Vol 2;23 (4;2) ◽  
pp. E175-E183
Author(s):  
Emad Zarief Kamel
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Nerve Conduction ◽  
Saline Solution ◽  
Controlled Clinical Trial ◽  
Tunnel Syndrome ◽  
Group 2 ◽  
Group 1

Background: Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy, which results from median nerve compression. A lot of nonsurgical modalities are available for the management of mild to moderate situations. Local Hyalase hydrodissection (HD) of the entrapped median nerve could offer a desirable sustained symptom alleviation. Objectives: To evaluate the clinical efficacy of Hyalase/saline solution carpal tunnel HD on pain, functional status, and nerve conduction in patients with CTS. Study Design: A randomized, double-blinded trial. Setting: Anesthesia, pain, and rheumatology clinics in a university hospital. Methods: Patients: 60 patients with CTS (> 6 months’ duration). Intervention: patients were allocated equally into either group 1 (HD with Hyalase + 10 mL saline solution injection), or group 2 (HD with 10 mL saline solution only). Measurements: assessment of pain using Visual Analog Scale (VAS), functional disability (FD) score, and nerve conduction studies before injection, and over 6 months after injection. Nerve conduction parameters before injection and postinjection by the end of 3 and 6 months were evaluated as well. Results: Statistically significant lower postinjection values of VAS (1 ± 1.8, 2 ± 1.1, 2 ± 1.2, 2 ± 1.1) in group 1 versus (2 ± 1.2, 3 ± 1.7, 4 ± 1.5, 5 ± 2.6) in group 2 by the end of the first week, and the first, third, and sixth months, and significantly lower FD scores (15.3 ± 1.2, 13 ± 1.3, 10.2 ± 1.3, 10.2 ± 1.3) in group 1 versus (17.5 ± 1.8, 16.6 ± 2.8, 19.4 ± 3.2, 21.2 ± 2.5) in group 2 during the same time intervals. Nerve conduction study parameters have shown significantly higher velocity and lower latency in the Hyalase group than in the saline solution group by the 3 and 6 month follow-up. Limitation: We suggest a longer period could be reasonable. Conclusions: Carpal tunnel HD with Hyalase with saline solution is considered as an efficient technique offering a rapid onset of pain relief and functional improvements, and better median nerve conduction in patients with CTS over 6 months follow-up duration. Key words: Carpal tunnel syndrome, Hyalase, median nerve hydrodissection

Single versus repetitive injection of lignocaine in the management of carpal tunnel syndrome – a randomized controlled trial

2014 ◽  
Vol 40 (2) ◽  
pp. 179-183 ◽  
Author(s):  
S. Akarsu ◽  
Ö. Karadaş ◽  
F. Tok ◽  
H. Levent Gül ◽  
E. Eroğlu
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Controlled Trial ◽  
Post Treatment ◽  
Randomized Controlled ◽  
Electrophysiological Findings ◽  
Tunnel Syndrome ◽  
Group 2 ◽  
Single Versus ◽  
Group 1

The aim of this study was to determine the efficacy of single versus repetitive injection of lignocaine into the carpal tunnel for the management of carpal tunnel syndrome. The 42 patients included were randomly assigned to two Groups: group 1 was injected with 4 mL of 1% lignocaine once and Group 2 was injected with 4 mL of 1% lignocaine twice a week for 2 weeks. Clinical and electrophysiological evaluations were performed at the study onset, and at 6 and 12 weeks following the final injection. Initially, the groups were similar with respect to clinical and electrophysiological findings. All parameters in Group 2 improved 6 weeks post treatment ( p < 0.05), and these improvements persisted at 12 weeks post treatment ( p < 0.05). Repetitive local lignocaine injection was effective in reducing the symptoms of carpal tunnel syndrome and improving electrophysiological findings.

scholarly journals Limited mid palmar versus extended incision in surgical treatment of carpal tunnel syndrome: Clinical analysis

2020 ◽  
Vol 24 (3) ◽  
pp. 360-366
Author(s):  
Jagar Doski ◽  
Reber Sindy ◽  
Farhad Hamzani ◽  
Hishyar Omar
Keyword(s):  
Surgical Treatment ◽  
Carpal Tunnel Syndrome ◽  
Return To Work ◽  
Carpal Tunnel ◽  
Operative Time ◽  
Daily Life ◽  
Daily Life Activities ◽  
Tunnel Syndrome ◽  
Group 2 ◽  
Group 1

Background and objective: There are different methods and incisions to release the transverse carpal ligament in carpal tunnel syndrome. This study aimed to compare the surgical outcome of the conventional extended incision with the limited mid palmar one. Methods: The study was a prospective comparative one. Patients with carpal tunnel syndrome were divided into two groups: Group 1 was patients operated on by the conventional extended incision, Group 2 with a limited mid palmar incision. Results: The patients included were 79 with 89 hands. The age mean was 41 years. Group 1 included 47, and Group 2 included 42 hands. The differences between both groups were statistically significant regarding the operative data (the incision length and the operative time) and the post-operative data (the duration of analgesia needed, the date of starting to use the hand in daily life activities, and return to work). However, the date of improvement of the sensory symptoms from the fingers showed no significant differences. The sum of the overall complications that occurred for the cases of Group 2 was about a third of that occurred for Group 1. The highly significant difference was in the scar tenderness in the third month of the post-operative period. Conclusion: The limited mid palmar incision to release the entrapment of median nerve in carpal tunnel syndrome offers a shorter operative time, less analgesia needed post-operatively, less complication rate, less scar tenderness, earlier use of the hand in daily life activities, and return to work in a shorter period. Keywords: Carpal tunnel syndrome; Surgical treatment; Incision.

The Use of Ultrasonography in Detection of Synovitis in Carpal Tunnel Syndrome

1993 ◽  
Vol 18 (2) ◽  
pp. 176-179 ◽  
Author(s):  
K. NAKAMICHI ◽  
S. TACHIBANA
Keyword(s):  
Rheumatoid Arthritis ◽  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Lymphocytic Infiltration ◽  
Idiopathic Carpal Tunnel Syndrome ◽  
Tunnel Syndrome ◽  
Group 3 ◽  
Group 2 ◽  
Inflammation Group ◽  
Group 1

The findings of pre-operative ultrasonography of the carpal tunnel were compared with synovial histology in 50 surgically treated wrists with carpal tunnel syndrome. Eight wrists with a massive hypoechoic area (group 3) had synovitis. 28 with a minimal hypoechoic area (group 1) had no evidence of inflammation. 14 with a moderately increased hypoechoic area (group 2) consisted of three with synovitis, four with lymphocytic infiltration and seven without inflammation. Group 3 strongly indicates synovitis, in which case one should consider aetiology other than the idiopathic cause. Bilateral synovial thickening suggests carpal tunnel syndrome as the initial clinical picture of rheumatoid arthritis, and group 1 indicates idiopathic carpal tunnel syndrome provided that there are no primary causes.

scholarly journals Minimally invasive modified Camitz opponensplasty for severe carpal tunnel syndrome

2018 ◽  
Vol 26 (2) ◽  
pp. 230949901877091
Author(s):  
Mitsuhiko Nanno ◽  
Norie Kodera ◽  
Yuji Tomori ◽  
Shinro Takai
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Minimally Invasive ◽  
Carpal Tunnel ◽  
Modified Technique ◽  
Abductor Pollicis Brevis ◽  
Thenar Muscle ◽  
Painful Wrist ◽  
Tunnel Syndrome ◽  
Group 2 ◽  
Group 1

Purpose: We aimed to compare the clinical results and the complications between the minimally invasive modified Camitz opponensplasty and the conventional Camitz opponensplasty for severe carpal tunnel syndrome (CTS), and to evaluate the efficacy of the modified technique for CTS. Methods: Twenty-eight hands in 24 patients with severe CTS who had disorder of the thumb opposition with thenar muscle atrophy (group 1) were treated by minimally invasive modified Camitz opponensplasty, passing the transferred palmaris longus (PL) tendon under the abductor pollicis brevis (APB) fascia using only palm and thumb incision, and no incision to either wrist crease or forearm. Ten hands in 10 patients (group 2) were treated by the conventional Camitz opponensplasty. Clinical evaluation was made by comparing the results before and after surgery for the angle of the thumb palmar abduction, pinch power, and grip strength. Results: All clinical findings significantly improved after surgery compared with before surgery in all patients. In group 1, there were no complications including transferred tendon bowstring, painful wrist scar, or injury to the palmar cutaneous branch of the median nerve in all hands. Conversely, patients in group 2 had four painful wrist scars and nine bowstrings of the transferred tendon. Conclusions: Several complications have been considered to attribute to the long incision and an extensive dissection crossing the wrist crease from the palm to the wrist in the conventional Camitz procedure. The current modified Camitz opponensplasty by minimally invasive incision without straddling the wrist crease is a simple and effective procedure that can decrease the risk of painful scar around the wrist crease in severe CTS patients with disorder of thumb opposition. Additionally, this technique, by passing the transferred PL tendon under the APB fascia, is useful in restoring the thumb opposition immediately, and in preventing the bowstringing of the transferred tendon.

scholarly journals The effects of nerve and tendon gliding exercises combined with low-level laser or ultrasound therapy in carpal tunnel syndrome

2019 ◽  
Vol 53 (2) ◽  
pp. 347 ◽  
Author(s):  
Małgorzata Eliks ◽  
Zuzanna Bartkowiak ◽  
Małgorzata Zgorzalewicz-Stachowiak ◽  
Leszek Romanowski
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Ultrasound Therapy ◽  
Low Level ◽  
Low Level Laser ◽  
Level Laser ◽  
Tunnel Syndrome

Evaluation of the Efficacy of Ultrasound Therapy in the Treatment of Patients with Carpal Tunnel Syndrome

2019 ◽  
Vol 11 (1) ◽  
pp. 24-27
Author(s):  
Nadia Siddiquee ◽  
Farzana Akonjee Mishu ◽  
Monzur Ahmed ◽  
Shaila Sharmin Shahnewaz ◽  
Hashina Bilkish Banu ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Controlled Trial ◽  
Ultrasound Therapy ◽  
Symptom Severity Scale ◽  
Group A ◽  
Tunnel Syndrome ◽  
Group B ◽  
Wrist Splint

This randomized controlled trial was conducted in Department of Physical Medicine and Rehabilitation of Bangabandhu Sheikh Mujib Medical University, Dhaka during the period from March 2014 to August 2014 to evaluate the effect of ultrasound therapy (UST) on patients of carpal tunnel syndrome. Total 110 subjects were participated in this study and they were selected randomly divided in two groups by lottery. Group-A was treated with UST, Exercise, Wrist splint, non steroidal anti inflammatory drugs (NSAIDs) and group-B received Exercise, Wrist splint and NSAIDs. Treatment continued for a period of 6 weeks. Group-A were compared to group B by both Visual Analog Scale (VAS) and Levine Symptom severity scale(LSSS) after 3 weeks and 6weeks of treatment. The result showed mean VAS at pretreatment (W0) in group-A was 6.42 ±1.23 and in group-B was 6.17±0.74. Group-A was 1.82±0.43 and in group-B was 3.1±0.23 in their follow up after 3 weeks (W 3) In Group-A was 1.71(±0.52) and in group-B was 2.52(±0.49) at 2nd follow up (W6) after 6 weeks. Mean LSSSat pretreatment (W0),1st follow up after 3 weeks (W 3), 2nd follow up (W 6) after 6 weeksin group-A was 31.64±1.55, 14.32 ± 2.29 and 14.31 ±1.12 respectively,and in group-B was 31.3±0.74,18.51±0.92and 18.31 ± 0.42 respectively.This study revealed that continuous mode of US therapy with exercise, wrist splint, NSAIDs have better outcome in case of Carpal tunnel syndrome patients. J Shaheed Suhrawardy Med Coll, June 2019, Vol.11(1); 24-27

scholarly journals Carpal Tunnel Syndrome Soft Relief Device for Typing Applications

2017 ◽  
Author(s):  
Mengjia Zhu ◽  
Wade Adams ◽  
Panagiotis Polygerinos
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Real Time ◽  
Carpal Tunnel ◽  
Severe Pain ◽  
General Trend ◽  
Working Population ◽  
Tunnel Syndrome ◽  
Neutral Angle

Carpal Tunnel Syndrome (CTS) affects roughly 3%–6% of the working population ages 18–64 [1]. This affliction is caused by applying stress on the median nerve that is routed through the carpal tunnel while it is at a positive or negative angle, greater than 15 degrees in either direction, to the human wrist [2]. The median nerve can become inflamed and swollen due to pressure from the palmar carpal ligament causing numbness, stiffness and in some cases severe pain. Tasks like typing can become nearly impossible when the median nerve is inflamed. A number of products on the market and research prototypes have been suggested that try to alleviate CTS strains, however, these designs are generally passive e.g. braces, splints, etc. Instead of actively trying to adjust the wrist angle, the general trend is to prop the wrist up with some sort of rigid ramp, similar to the bottom of a keyboard [3]. The goal of this work is to design a wearable, soft-actuated, robotic sleeve that will dynamically adjust the position of the wrist in real-time to a neutral angle to prevent or release CTS strains.

scholarly journals Carpal tunnel syndrome caused by thrombosed persistent median artery - A case report -

2020 ◽  
Vol 15 (2) ◽  
pp. 193-198
Author(s):  
Sang Yoon Jeon ◽  
Kwangmin Lee ◽  
Weon-Joon Yang
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Severe Pain ◽  
Rare Case ◽  
Conservative Therapy ◽  
Cervical Radiculopathy ◽  
Resonance Imaging ◽  
Chief Complaints ◽  
Tunnel Syndrome ◽  
Median Artery

A rare case of carpal tunnel syndrome caused by a thrombosed persistent median artery is presented here. The diagnosis was delayed due to the overlapping cervical radiculopathy. Acute severe pain and nocturnal paresthesia were chief complaints. Ultrasonography, magnetic resonance imaging, and computed tomography angiography revealed that the median nerve was compressed by the occluded median artery. Instead of surgery, conservative therapy was tried. It worked well for six months. The importance of using modalities for decision making of diagnosis and treatment is emphasized in this report.

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