A Taiwanese study finds that ultrasound therapy is more effective than kerosene in the treatment of carpal tunnel syndrome.
Report by Prof. Dr. Hannu Luomajoki
In a study published in BMC msuculoskeletal disorders, 60 patients who had electroneurographic (ENMG) and clinically confirmed carpal tunnel syndrome (CTS) were divided into two therapy groups. In both groups, the patients received a night splint and, in addition, either ultrasound therapy or a kerosene bath twice a week for eight weeks.
In this methodologically well-conducted study, the most important result was the self-administered Boston KTS questionnaire. In the questionnaire, the subjects self-assessed the functional ability of the hand. Strength, sensitivity and ENMG tests were carried out as secondary outcomes.
Both groups showed statistically significant improvements in both subjective and physical outcomes. Function and pain were significantly better in the ultrasound group than in the kerosene bath group. In the physical measurements (strength, sensitivity and ENMG measurements) there were no statistically significant differences between the groups.
The authors conclude that ultrasound therapy was the better choice of treatment for KTS compared to kerosene treatment. Since both treatment methods produce heat and thus an improvement in blood circulation, but only ultrasound produces physical effects (metabolic improvement), the authors of the study hypothesize that this is the reason for the group difference.
Comment by Prof. Dr. Hannu Luomajoki:
Ultrasound is a well-established physical treatment for various musculoskeletal complaints. However, its effectiveness is often doubted. This study shows the superiority of ultrasound treatment for CTS in a close and fair contrast to superficial heat application only. Overall, the therapy was very pragmatic: a night splint for 8 weeks plus either ultrasound or a kerosene bath twice a week. The dosage of ultrasound was 5 minutes 1 W / cm2 pulsed ¼. It can be questioned whether the results would be even better with more frequent application and combined with active measures, which were not mentioned in the study.
Source: Comparative effectiveness of ultrasound and kerosene therapy in patients with carpal tunnel syndrome: a randomized trial (2014) : Yi-Wei Chang, Shih-Fu Hsieh, Yu-Shiow Horng, Hui-Ling Chen, Kun-Chang Lee and Yi-Shiung Horng BMC Musculoskeletal Disorders 15:399
