title: Phonophoresis of dexamethasone sodium phosphate may manage pain and symptoms of patients with carpal tunnel syndrome.
abstract: OBJECTIVE
  This study was designed to compare the efficacy of iontophoresis and phonophoresis of dexamethasone sodium phosphate (Dex-P) treatment for mild to moderate carpal tunnel syndrome (CTS).
  
  
  METHODS
  Fifty-two hands in 34 consecutive patients with mild to moderate CTS confirmed by electromyography were allocated randomly into 2 groups. One group received iontophoresis of 0.4% Dex-P and the other group received phonophoresis of 0.4% Dex-P. Phonophoresis (using ultrasound 1 MHz, 5-cm probe, 1.0 W/cm, pulse 1:4, 5 min/session) and iontophoresis (using galvanic current, negative electrode, 2 mA/min, total dose 40 mA for 20 min) was applied over the wrist chin for 10 daily treatment sessions (5 sessions/wk). Measurements were performed before and after treatment and at follow-up 4 weeks later, and included pain assessment by visual analogue scale, electroneurographic measurement (motor and sensory latency, motor and sensory action potential amplitude), and pinch and grip strength.
  
  
  RESULTS
  Improvement was significantly more pronounced in the phonophoresis group than in the iontophoresis group for motor latency [mean difference 0.8 m/s; 95% confidence interval (CI), 0.5-1.1], motor action potential amplitude (4.1 mV; 95% CI, 3.0-5.2), finger pinch strength (31.6 N; 95% CI, 15.9-47.3), hand grip strength (27.1 N; 95% CI, 13.5-40.5), and pain relief (2.1 points on a 10-point scale; 95% CI, 1.3-2.9). Effects were sustained in the follow-up period.
  
  
  CONCLUSIONS
  Phonophoresis of Dex-P treatment was more effective than iontophoresis of Dex-P for treatment of CTS. Further study is needed to investigate the combination therapy effects of these treatments with other conservative treatments in CTS patients.
authors.affiliation: Neuromuscular Rehabilitation Research Center, Rehabilitation Faculty, Semnan University of Medical Sciences, Semnan, Iran. amirbakhtiary@sem-ums.ac.ir
authors.forename: Amir H
authors.initials: AH
authors.lastname: Bakhtiary
authors.forename: Elham
authors.initials: E
authors.lastname: Fatemi
authors.forename: Mitra
authors.initials: M
authors.lastname: Emami
authors.forename: Mojtaba
authors.initials: M
authors.lastname: Malek
mesh_terms: D000200:Action Potentials / Q000187:drug effects / Q000502:physiology; D000328:Adult; D002349:Carpal Tunnel Syndrome / Q000188:drug therapy* / Q000503:physiopathology; D003907:Dexamethasone / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D004576:Electromyography; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage / Q000627:therapeutic use*; D018737:Hand Strength / Q000502:physiology; D006801:Humans; D007478:Iontophoresis; D008297:Male; D008875:Middle Aged; D009431:Neural Conduction / Q000187:drug effects / Q000502:physiology; D010147:Pain Measurement; D015612:Phonophoresis; D016896:Treatment Outcome
chemical_list: D005938:Glucocorticoids; C004180:dexamethasone 21-phosphate; D003907:Dexamethasone