The Comparison of Therapeutic Ultrasound and Local Steroid Injection in Treatment of Mild to Moderate Carpal Tunnel Syndrome: A Randomized Controlled Trial

Abstract

Background: Carpal tunnel syndrome (CTS) is the most commonly known entrapment neuropathy in which median nerve of the body is compressed or traumatized. The problem is described by numbness and tingling sensation in the region of tangible dispersion of the nerve in the hand that is joined by torment as well as shortcoming of thumb muscles. The incidence rate of CTS is 139/100,000 per year for men and 506/100,000 per year for women.
Objective: To compare the difference in pre/post numeric pain rating scale scores (NPRS) and Boston Carpal Tunnel Syndrome Questionnaire Scores (BCTSQ) with the use of therapeutic ultrasound versus local steroid injection in the treatment of mild to moderate carpal tunnel syndrome.
Methodology: A randomized clinical trial was done at Mayo Hospital Lahore, after the approval of synopsis from March 2016 to August 2016.The sample size of 60 patients (30 subjects in every group) was assessed by utilizing 5% level of significance, 90% power of test with expected mean estimation of BCTSQ score of local steroid as 3.20 and therapeutic ultrasound as 2.39 using simple random technique. Patients were given treatment with therapeutic ultrasound along with tendon gliding exercises in one group and local steroid injection along with tendon gliding exercises in another group. Post treatment assessment was done after four weeks.
Results: Pre-treatment pain intensity mean±SD for group 1 was 2.900±0.80 and for group 2 were 2.77±0.82 that was changed to 1.67±1.18 and 21.63±1.07 after four week treatment respectively. The functional status score mean±SD before treatment was 2.51±0.30 on symptom severity scale, 2.42±0.32 on functional status scale for group 1and 2.32±0.34 (SSS), 2.17±0.45 (FSS) for group 2 that were changed after four week treatment to 1.94±0.44 (SSS), 1.89±0.51 (FSS) and 1.97±0.27 (SSS), 1.78±0.42 (FSS) for group 2 respectively.
Conclusion: The patients who were treated with therapeutic ultrasound method (U/S Group) showed better recovery after treatment, in case of symptoms severity scale. In case of function status scales the patients who were treated with local steroid method (Injectable Group) recovered better after treatment.