ULTRASOUND TREATMENT FOR TREATING THE CARPAL-TUNNEL SYNDROME - RANDOMIZED SHAM CONTROLLED TRIAL

Objective: To assess the efficacy of ultrasound treatment for mild to moderate idiopathic carpal tunnel syndrome. Design: Randomised, double blind, ''sham'' controlled trial with assessments at baseline, after 2 weeks' and 7 weeks' treatment and at a follow up assessment 6 months later (8 months after baseline evaluation), Setting Outpatient clinic of a university department of physical medicine and rehabilitation in Vienna. Subjects: 45 patients with mild to moderate bilateral carpal tunnel syndrome as verified by electroneurography. Intervention: 20 se ssions of ultrasound (active) treatment (1 MHz, 1.0 W/cm(2), pulsed mo de 1:4, 15 minutes per session) applied to the area over the carpal tu nnel of one wrist, and indistinguishable sham ultrasound treatment app lied to the other. The first 10 treatments were performed daily (5 ses sions/week); 10 further treatments were twice weekly for 5 weeks. Main outcome measures: Score of subjective symptom ratings assessed by vis ual analogue scale; electroneurographic measures (for example, motor d istal latency and sensory antidromic nerve conduction velocity). Resul ts: Improvement was significantly more pronounced in actively treated than in sham treated mists for both subjective symptoms (P < 0.001, pa ired t test) and electroneurographic variables (motor distal latency P < 0.001, paired t test; sensory antidromic nerve conduction velocity P < 0.001, paired t test). Effects were sustained at 6 months' follow up. Conclusion: Results suggest there are satisfying short to medium t erm effects due to ultrasound treatment in patients with mild to moder ate idiopathic carpal tunnel syndrome. Findings need to be confirmed, and ultrasound treatment will have to be compared with standard conser vative and invasive treatment options.