Effect of Low-Level Laser Therapy Combined with Therapeutic Ultrasound on Hand Pain and Function Following Carpal Tunnel Syndrome: A Randomized Controlled Trial

Background: Carpal tunnel syndrome (CTS) is the most prevalent compression neuropathy in the upper extremity. Objectives: The present study aimed to compare ultrasound and laser therapies separately and together in relieving hand pain and improving performance in mild and moderate CTS patients. Methods: In this single-blind trial, 45 patients (84 wrists) suffering from CTS were randomly divided into three treatment groups: the ultrasound and laser combination group (15 patients), the ultrasound therapy group (15 patients), and the laser therapy group (15 patients). Low-level laser therapy (total intensity of 9 J on 5 points) and ultrasound therapy (intensity of 1.25 W/cm and duty cycle of 20% for 5 minutes per session) were applied on the carpal tunnel for 10 sessions. For the ultrasound and laser combination group, the laser was first conducted in the same way for the laser therapy group, and ultrasound was performed immediately after, with the same parameters as those of the ultrasound therapy group. A visual analog scale (VAS), grip strength, pinch strength, and the Boston Questionnaire results were evaluated before and after the treatment. Results: All three treatment groups (the ultrasound and laser combination group, the ultrasound therapy group, and the laser therapy group) demonstrated significantly improved VAS (P=0.000, P = 0.000, and P = 0.000, respectively), grip strength (P = 0.003, P = 0.001, and P = 0.01, respectively), pinch strength (P = 0.000, P = 0.004, and P = 0.002, respectively), and Boston questionnaire results (P = 0.000, P = 0.000, and P = 0.000, respectively). However, a comparison of treatment groups' mean changes indicated no significant difference among them (P > 0.05). Conclusions: Both ultrasound and laser modalities effectively relieve pain and improve functional hand performance in patients with mild and moderate CTS in the short term. The compound use of these two modalities may have a greater impact in treating these patients.