title: Pain and electrophysiological parameters are improved by combined 830-1064 high-intensity LASER in symptomatic carpal tunnel syndrome versus Transcutaneous Electrical Nerve Stimulation. A randomized controlled study.
abstract: OBJECTIVE
  The aim of the study was to compare LASER versus transcutaneous electrical nerve stimulation (TENS) in reducing pain and paraesthesia; and in improving motor and sensory median nerve conduction parameters in mild to moderate carpal tunnel syndrome (CTS).
  
  
  METHODS
  Randomised blinded pilot study. Patients and staff administered treatments and outcome measures were blinded.
  
  
  METHODS
  Outpatient; Research and Care Rehabilitation Institute.
  
  
  METHODS
  Twenty CTS symptomatic patients.
  
  
  METHODS
  Fifteen sessions of: 1) 100 Hz TENS (30 minutes; rectangular waves; 80 ms width, intensity below muscle contraction); 2) combined 830-1064 nm LASER (radiating dose: 250 J cm-2 delivered to the skin overlying the course of the median nerve at the wrist for 100 s at 25 W (18 W [1064 nm] + 7 W [830 nm]) via a fiber-optic probe with a spot size of ~1 cm2). Outcome measures. Visual analogue scale (VAS) for pain and paresthesia; median nerve distal motor latency and sensory nerve conduction velocity.
  
  
  RESULTS
  LASER improved both positive and negative sensory symptoms. TENS induced clinical improvement but this was not statistically significant and was limited to pain reduction. LASER but not TENS favourably modified the neurophysiological parameters.
  
  
  CONCLUSIONS
  High-intensity combined LASER wavelengths of 830 nm and 1064 nm, which produce a better transparency with less scattering and a high energy transfer, are better than TENS in improving both pain and paraesthesia as well as neurophysiological parameters in CTS.
authors: Department of Clinical Neurophysiology and Pain Rehabilitation Unit, Salvatore Maugeri Foundation, IRCCS, Research and Care Rehabilitation Institute of Montescano, via per Montescano 42, Montescano, Pavia, Italy. roberto.casale@fsm.it
authors: R
authors: R
authors: Casale
authors: C
authors: C
authors: Damiani
authors: R
authors: R
authors: Maestri
authors: C D
authors: CD
authors: Wells
mesh_terms: D000328:Adult; D000368:Aged; D002349:Carpal Tunnel Syndrome / Q000628:therapy*; D005260:Female; D005336:Fiber Optic Technology; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D059408:Pain Management; D010147:Pain Measurement; D010865:Pilot Projects; D004561:Transcutaneous Electric Nerve Stimulation; D016896:Treatment Outcome