THU0543 Comparison of the effectiveness of low level laser therapy and steroid injection in moderate carpal tunnel syndrome: a randomised controlled trial
Authors: S. Badıl Gülo&gbreve;lu, M. Bilgilisoy Filiz, K.K. Kılıç, S. Koldaş Do&gbreve;an, I. Erdem Toslak, N.F. Toraman
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Recent studies have reported that low-level laser therapy (LLLT) reduces pain and improves function in carpal tunnel syndrome (CTS). However, to the best of our knowledge, there exist no studies that compares the effectiveness of LLLT and steroid injections in moderate CTS. <h3>Objectives</h3> Is to evaluate the effectiveness of LLLT and steroid injection in moderate CTS, by comparing the symptoms, the electrophysiologic and the Magnetic Resonance Imaging (MRI) findings of the patients. <h3>Methods</h3> 87 patients with moderate CTS were included in the study. 87 patients were randomised to the steroid or LLLT groups. LLLT was applied to the carpal tunnel area (6 joules/5 min) five times per week, for a total of 10 sessions. Steroid injections were performed once after randomization. Numbness and pain of the patients were assessed using a Visual Analogue Scale (VAS), disability was assesses using the Quick arm-shoulder-hand (Quick DASH) disability questionnaire. Rough and fine grasping strength tests, Tinel and Phalen tests and electrophysiological test were performed. All the patients were evaluated by MRI in terms of median nerve cross-sectional area, median nerve intensity and intensity rate, and median nerve palmary spring rate. All tests were performed before the treatment, and 1. month and 6. months after the treatment, except the MRI evaluations, which were done before and after 6. months of the treatment. <h3>Results</h3> The study was completed with 80 patients, 133 wrists at the end of six months. There were no significant differences between the groups in terms of dermographic and baseline clinic characteristics, electrophysiologic and MRI findings of the patients (p&gt;0,05). While the VAS scores of numbness and pain and Quick Dash symptom scores were better in the steroid group in the first month, there were no significant differences between the groups in the sixth month. In both groups, there were similar significant improvements in the Phalen and Tinel tests, rough and fine grasping forces, median nerve motor distal latency value in the first and sixth months after the treatment in comparison to pretreatment values (p&lt;0.05). Median nerve sensory distal latency and median sensory NCV showed significant improvements in the 1st and the 6th months after treatment in comparison to pretreatment only in the steroid group (p&lt;0.05). In both groups, there were similar significant improvements in the median nerve intensity rate in the radioulnar plane and median nerve palmary spring rate on the MRI after the treatment. Median nerve intensity rate was improved in both groups also at the pisiform plane but this improvement was significant only in the steroid group. <h3>Conclusions</h3> It is possible to conclude that LLLT reduces the signs and symsptoms of the patients who has moderate CTS as well as the steroid treatment. Our study offers a data regarding LLLT's efficiency in short-intermediate terms. Further studies are needed to make comments about long-term efficiency of LLLT. LLLT is a noninvasive treatment option in moderate CTS and with a similar efficacy as steroid treatment. <h3>Reference</h3> [1] Evcik D, Kavuncu V, Cakir T, Subasi V, Yaman M. Laser therapy in the treatment of carpal tunnel syndrome: a randomized controlled trial. Photomed Laser Surg2007;25:34–39. <h3>Disclosure of Interest</h3> None declared