Effect of Low Level Laser Therapy Versus Pulsed Ultrasound
Condition: Carpal Tunnel Syndrome; POSTPARTUM CARPAL TUNNEL SYNDROME
MeSH terms: Carpal Tunnel Syndrome; Syndrome
Study type: Interventional

Summary: 
      Carpal tunnel syndrome (CTs), the most common entrapment neuropathy of the upper extremity,
      is caused by compression of the median nerve as it travels through the carpal tunnel.

      CTs was clinically diagnosed in more than half of women (62%). Neurophysiological evaluation
      diagnosed that CTs in around half of women (43%) was positive in one hand at least, also, it
      was reported that about half of women with CTs during pregnancy still complained of CTs
      symptoms one year after delivery.
    

Detailed description: 
      Carpal tunnel syndrome pain and discomfort during postpartum period may interfere with the
      mother ability to successfully breastfeed due to increased physical load on the mother's
      hands and repetitive need for flexion during breastfeeding and carrying of the baby.

      Observation of peripheral oedema in about 80% of pregnant women, especially in the period of
      third trimester is common, it is due to hormonal changes that cause reduction of venous
      return, fluid retention which decrease the carpal tunnel diameter and increase compression of
      the median nerve. Also, increase production of relaxin hormone leads to relaxation of the
      transverse carpal ligament and flattening of it that increase compression of the median
      nerve.

      Symptoms of CTs differ from tingling, numbness and palmar side pain in radial 3.5 fingers.
      Typically, at night, patients are awakened by a numb hand. Complaints like decrease in hand
      strength, difficulty of holding things and dropping are common. Sensory distribution, median
      nerve hypoesthesia, positive provocative tests and atrophy or weakness of the thenar muscles
      may be shown in physical examination.

      Nerve conduction study (NCS) has been showed as the gold standard in the diagnosis of CTs
      since it provides information about the physiological health of median nerve over the carpal
      tunnel. NCS measures sensory and motor nerve action potential which determines the severity
      of nerve entrapment.

      Conservative treatment of CTs includes; local steroid injection, non-steroidal
      anti-inflammatory drugs, splinting, modification of activity, physical therapy modalities
      like ultrasound, low level laser therapy and stretching exercises.

      Low level Laser therapy (LLLT) has analgesic and anti- inflammatory effect. Also, LLL
      improves the metabolic processes and increases protein synthesis that improves blood flow,
      blood vessel health and cell regeneration.
    

Intervention name(s): low level laser therapy
Intervention type(s): Radiation
Intervention description(s): comparing between the effect of low level laser therapy (LLLT) and pulsed ultrasound on post-partum carpal tunnel syndrome. All interventions that were pre-specified to be administered as part of the protocol, even if a particular intervention is not "of interest
Other intervention name(s): pulsed ultrasound waves
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Treatment